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Private Payers Need to Join Humana, CMS With EHR Subsidies

Posted on June 30, 2011 I Written By

Ever since the American Recovery and Reinvestment Act became law in February 2009, giving birth to the phrase “meaningful use,” I’ve wondered when private insurers would follow the federal government’s lead and start offering financial carrots and sticks for using and not using EHRs. After all, one of the purposes of the Medicare and Medicaid incentive program was to address the fact that payers tend to reap the greatest financial gains from hospitals and physicians adopting EHRs, even though most if not all of the cost of acquiring the technology falls on the provider.

Federal officials have made it clear all along that “meaningful use” is just that, the meaningful use of the technology. The government was not simply going to write checks so providers could go out and buy technology. As the country’s largest purchaser of  healthcare services, CMS wanted some value for its money (not exactly something you hear every day when it comes to government spending).

I’d been hearing for years that major commercial health insurers also were willing to share some of the savings from EHR adoption, but not until the largest payer of them all, Medicare, did so first. The private sector usually does follow Medicare’s lead when it comes to major policy shifts. Medicare now has done so, but private payers have been mostly silent. Mostly.

This month, as InformationWeek reports, Humana teamed up with Allscripts Healthcare Solutions to offer physician practices financial incentives for purchasing Allscripts EHR systems. The deal is similar to one Humana cut last year with Athenahealth. A few Blue Cross and Blue Shield plans, notably in Massachusetts and Rhode Island, have led similar programs at the state level, with eClinicalWorks the main partner.

But unless I’m forgetting something, Humana is the only big payer that has jumped into the game. Where are the UnitedHealthcares, Aetnas, Cignas and WellPoints of the world?

Payers, it’s time to make good on the lip service you gave years ago and start passing on some of the savings you will realize from Medicare, Medicaid and hundreds of thousands of providers spending billions of dollars on EHR technology and health information exchange efforts.

 

Meducation SMART app Wins Children’s Hospital Boston and Harvard Medical School Health App Competition

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If the winner of this contest is any indication of the level of development necessary for success in future competitions, developers better bring their “A” game.  The Meducation SMART app provides a great range of abilities that make it a truly dynamic tool.

From the official press release:

“The SMART (Substitutable Medical Applications, Reusable Technologies) Platform Apps Challenge tasked developers with creating web applications that would interface with an electronic medical record (EMR) or personally controlled health record (PCHR) and demonstrate value to patients, physicians, or public health researchers.”

So what exactly does the Meducation app do?  It helps patients to better understand the medications they are taking through proper instructions, warnings, and, for more complicated medications, even has video demos. The medications available are pulled directly from the patient record so you get the information that is relevant to you.

Another useful feature that is becoming more important is that it can translate into 12 different languages, including english.  What I mean by that is the instructions are given at a 5th-6th grade level so they are easy to understand for almost anyone.  This makes it far less likely for patients to get confused and risk their health through misuse.

For the official press release for the contest please go here.

For more information about the Meducation SMART app please visit their contest page.

Jim Tate’s EHR Incentive Roadmap Resource

Posted on June 29, 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.


HITECH Answers has just released the 3rd edition of Jim Tate’s The Incentive Roadmap® The Meaningful Use of Certified Technology: Stage 1 A Manual for Medical Practices. Version 3.0 of the manual that has been helping practices, consultants and vendors across the country understand the step-by-step process of achieving meaningful use is now available. Written by Jim Tate, a nationally recognized expert on the CMS EHR Incentive Program, certified technology and Meaningful Use objectives,The Incentive Roadmap® looks at what steps are needed to get ready for meaningful use and is downloaded immediately upon purchase.

I consider Jim Tate one of the foremost experts on meaningful use and certified EHR. So, I was excited when he decided to publish a resource on the details of the EHR incentive program.

In The Incentive Roadmap®, Jim Tate covers all of the details that you need to know if you’re considering participation in the EHR incentive program.

The first section is actually incredibly valuable since it covers who is eligible for the EHR incentive money and also includes a comparison of the various EHR incentive programs. Plus, it walks a clinic through the process of determining which program it is eligible for. Certainly many people have already gone through this process, but for the rest of you this is a great resource that will guide you through the EHR incentive options.

The next section of the The Incentive Roadmap® covers the details of the meaningful use criteria. This is the section that I think most people will be interested in having now. Certainly many of these details can be found on the CMS website and we’ve covered a lot of them in our Meaningful Use Monday series. However, if you want to get all of the meaningful use details in one place without all the legalese that CMS loves to provide, then check out the The Incentive Roadmap®.

I also love a later section of the The Incentive Roadmap® where Jim Tate provides some practical strategy advice on how a clinic should approach meaningful use.

I know I’ll be keeping my copy of The Incentive Roadmap® close by as a reference. It’s a lot easier to go through than the HHS/CMS/ONC websites.

Jan Patterson, Office Manager of West Broadway Clinic – Force Behind its MU Implementation and Attestation Process

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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.


West Broadway Clinic has three physicians and two PA’s – all three physicians successfully attested to Meaningful use on April 20, 2011. The practice encompasses multiple specialties including family medicine, internal medicine, endocrinology, diabetes, women’s healthcare and offers onsite x-ray, dexa scan and vasectomies. The following interview is with Jan Patterson, the Practice Manager who drove the MU process and attestation.

1.    How did you learn about and select Cerner as your EHR?

At West Broadway Clinic in Council Bluffs, Iowa, we learned about Cerner Corporation through a local hospital. After extensive research into Cerner and several other vendors, we made the decision that the integration of Cerner’s Practice Management System and Ambulatory EHR would be the most beneficial to our organization.

2.    What’s your take on EHR certification and did that influence your EHR selection process?

The EHR certification is a vital piece for being able to meet the CME incentive requirements, and we feel that we are practicing better medicine and using our EHR solution more efficiently after receiving certification. We selected our EHR well in advance of the reporting process, so it was not a major influence in the selection process. Still, we have been very pleased with how efficient our EHR solution has been with assisting us in reaching certification.

3.    How long has your office been using an EHR?  Is this your first EHR?

West Broadway Clinic started using an EHR in May of 2008 when our office opened. Prior to the clinic opening the providers were not using an EHR – but the providers made it an initiative to start the clinic on an electronic solution. We knew we would be up and running with an electronic solution on day one. This included an EHR and practice management solution.

4.    Would you walk us through the process you followed to meet the meaningful use requirements and how did Cerner assist you in the process?

In order for West Broadway Clinic to be able to meet the Meaningful Use requirements an extensive amount of time was spent by the practice administrator attending webinars provided by Cerner Corporation regarding Meaningful Use, as well as researching the CME website and examining materials available through Medical Group Management Association, MGMA. In addition, Cerner arranged a Meaningful Use summit at our office for our office along with several of the Cerner user groups in our area – this consisted of several Cerner associates highlighting important parts of Meaningful Use, answering questions and making suggestions to assist with the process to successfully attesting. Upon compiling the requirements, time was spent one-on-one with both the providers and the clinical staff to ensure that everyone fully understood the requirements and how to use the EHR to meet the requirements.

5.    How many of the meaningful use requirements were you able to meet with little or no effort because you were already doing them? Did the Cerner EHR affect this?

West Broadway Clinic was able to meet 9 of the meaningful use requirements with little or no effort since as were already conducting several of these requirements through the use of our EHR. The use of the Cerner EHR and the elements that were already built into the EHR were the major factor we were able to meet these requirements so easily. Additionally, as we ran into any issues – we were able to contact Cerner’s Meaningful Use team (a group of designated associates) to assist, which eased the process.

6.    Which meaningful use requirements did your clinic find most challenging to meet and why?

Probably the most challenging Meaningful Use requirement for our clinic was encouraging all of the providers to use the electronic prescription function. However, once they understood the necessity of using electronic prescriptions and became comfortable with the function they have continued to increase the number of electronic prescriptions they are sending to the pharmacies.

7.    How long did the actual process take for you to fully comply with the meaningful use requirements?

West Broadway Clinic worked in earnest to be fully complying with the Meaningful Use requirements as quickly as possible after the beginning of 2011. These efforts allowed us the opportunity to be able to attest on April 20, 2011 – two days after attestation opened.

8.    Is meaningful use of a certified EHR helping your patients receive better care? Why or why not?

West Broadway Clinic has seen many positive changes in patient care with the use of a certified EHR. With the use of Cerner’s Ambulatory EHR our staff has the ability to have the most current visit information and patient history at our fingertips. Patients receive more continuity of care due to the fact that regardless of what provider they are seeing within our office the provider can quickly and easily track what services and/or medications a different provider has provided the patient. We deliver a better quality of care and we’ve enhanced safety measures through our use of the EHR. Components such as eprescribe, medicine/drug interactions, allergy checks, complete documentation, immunization schedules, growth charts, etc., have made us more efficient throughout the office from billing to practice management to prescribing medications and providing more thorough care in the patient’s room.

9.    What was the driving motivation for your clinic to show meaningful use?  And why be one of the first to show meaningful use?

West Broadway Clinic is committed to providing excellent patient care and providing patient’s with the opportunity to benefit from the latest in technology. With meaningful use of an EHR our patients are afforded these opportunities. By being one of the first groups of providers to meet the Meaningful Use requirements and report on them successfully, we are further able to show our commitment to our patients and their healthcare.

10. As a practice manager, what techniques did you use to get your physicians on board with meaningful use and EHR?

As a practice we had been discussing Meaningful Use for over a year and as the time grew near to implement the process the physicians were fully aware of the expectations and requirements and the benefits that would be provided to our patients. A lot of communication went into ensuring that all of the physicians were on board.

11.  Would you recommend that every health clinic show meaningful use and adopt an EHR? Why or why not?

After being on an EHR for more than three years I cannot imagine trying to function efficiently with a paper system. While the training period was stressful at times and it took the physicians a while to adjust, the benefits far outweigh any of the pain points. In addition, the opportunity to be able to transmit and receive patient information from other facilities in the future will only continue to enhance our patient care and the delivery of quality patient care is why we are practicing medicine in the first place.

12.  For all healthcare professionals reading this interview, what advice would you give them in starting the meaningful use process?

For anyone starting the Meaningful Use process, my advice is to first gather all of your information and facts. It is vital to be clear on the direction you need to take in order to ensure that all of the requirements are being met. In addition to thoroughly explaining all of the requirements to your physicians/staff and gaining their buy-in communicate with your staff and ensure that they fully understand the benefits and the necessity of meeting the Meaningful Use requirements, which is primarily to use your electronic records in a successful, meaningful way that will enhance the delivery and quality of care that your office provides. Remember the main reason why you are attesting, the money is a great incentive – but the biggest factor in successfully attesting is the benefit to your patients. Anyone can purchase an EHR and use it unsuccessfully or at its minimal functionality – to use it to it’s very best ability and to meet the requirements set forth by the Meaningful Use standards is to practice better medicine for your patients and to encourage others in your field to make quality care the highest priority.

13.  What remains your greatest EHR challenge post EHR implementation and meaningful use?

The greatest challenge for EHR and Meaningful Use continues to be the necessity to ensure that all the physicians and staff are continuing to maintain their high level of entering the correct and necessary data in patient’s charts to enable us to increase our reporting requirement levels far after successfully attesting. I have continued to monitor my staff’s levels after attestation and I’ve found that their numbers continue to increase – which is a positive realization for our staff and for our patients. It will also be imperative that we continue to monitor any new information coming out of CME and Cerner regarding meaningful use requirements especially as we gear up for Phase 2.

14.  What’s been the biggest benefit to your clinic of having an EHR?

West Broadway Clinic has benefited from having an EHR in multiple ways from never having to track down a paper chart to the continuity of care it provides for our patients. Having an EHR that integrates with our Practice Management System has reduced the amount of time it takes for charges to be entered and then forwarded to insurance companies. The adoption of an EHR has enabled West Broadway Clinic to become more efficient and be able to focus more upon the patient as a person. The increased benefits of safety cannot be undersold. With the assistance of the EHR, we are practicing better, safer medicine than we could on paper records.

EMR is the Health Care ERP

Posted on June 28, 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.

I know I’ve written about ERP and EMR before, but the more I think about the EMR selection and implementation process, the more I see the same issues that are experienced with an ERP implementation.

The one issue that is a bit different about EMR versus ERP is that there are only a small handful of ERP vendors to choose from. However, we have 300-600 to choose from in the EMR world. That’s an important and challenging difference.

However, the similarities to ERP are many. One of the most striking is how the EMR like the ERP is something that’s going to be used and have an effect on the entire organization. As such, the need to manage the participation of multiple stakeholders is so key.

The key to a successful ERP implementation is to have a great project leader.  Someone who is great at working with various departments. They are great listeners who hear and understand each departments needs. Then, they have to be great at making the case for each depaartment’s needs.

The same is true for EMR. You need an EMR implementation champion who is great at listening to all areas of the clinic: nurses, doctors, front desk, billing, medical records, etc. Sometimes this can be done well by a physician lead, but is more likely to be a practice manager, IT support (if they have project management skills), or an outside consultant. 

It’s easy to underestimate the challenge of “herding sheep.” Done right, it can work very well. Done wrong and your clinic is likely going to have the opportunity to try again after the failed EMR implementation.

There are other comparisons worth considering, but this one was striking me today. I’ll be interested to hear stories and experiences from those who have implemented an EMR. Did you have a strong leader to help pacify the different stakeholders in your clinic? 

IBM Study Reveals Health Gadget of the Future Requirements

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Developing a health gadget has got to be tough.  You invest tons of time and money developing something that may never pan out.  A new study from IBM is shedding some light on what people are looking for in healthcare gadgets and what it will take for developers to tap into the market.

There are a few specific areas that the study mentions that are showing lots of promise.

Dieting

There are already plenty of apps and gadgets for weight-loss, but in the future consumers are going to demand are lot more than counting calories or tracking exercise.  Consumers want a proactive gadget that will motivate them to get up and do more.  They want to be held accountable for their activity, or lack thereof.  They also want inter-connectivity especially with social media where they can share their success, and struggles, with their friends and family.

Elderly

I have already written about a tracking bracelet that could mean a lot to people with autism or alzheimers.  Improvements in mobile apps could improve the lives of all elderly.  Being able to track their movement and help them monitor their movement can help them stay active, and also help prevent injury by alerting the consumer that they may be nearing a fall.  They could also help in huge ways with ensuring elderly people are taking their medications, and doing so properly.

Blood Monitoring

Devices of the future could provide non-intrusive blood monitoring.  This would allow doctors to monitor their patients’ health at a whole new level.  Doctors would be almost immediately alerted to increased white blood cells that could help prevent infection, or at the very least slow it down and make it better.

No matter what health condition the app or gadget is trying to address, there are three major aspects that the study found to be of the most importance: ease of use, reasonable pricing, and real-time information sharing.  96 percent of people in the study said ease of use was most important in choosing one device over another.  The study slotted $100 as the magic number for reasonable cost.  86 percent of participants want real-time, easy to understand feedback from their devices.

There is no denying that the future is very bright for health care gadgets and apps, and thanks to this study developers have  a better idea of what to shoot for.

The full report can be found here, or for the condensed version you can find the press release here.

Cerner EHR Making a Difference at the Walnut Lake OB/GYN

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“I am a better physician now than I was before I used electronic medical records.”

Peek into a day in the life at Walnut Lake OB/GYN in West Bloomfield, MI. Practicing physicians Dr. Katz and Dr. Salesin invite you to learn how their five-provider office utilizes Cerner technology to provide enhanced, more efficient care to patients.

Walnut Lake OB/GYN Benefits:

* Annual savings of $10K in paper chart supplies
* Malpractice insurance decreased by 10%
* Women’s Health PowerNote content
* Real-time results from DMC via Cerner Hub

Walnut Lake Ob/Gyn is a Women’s Health practice in the Detroit area. Its mission is to provide comprehensive quality healthcare for all women, to promote healthy behavior in all patients and to provide a safe and comfortable environment to discuss all issues affecting patient health. www.walnutlakeobgyn.com

 

 

Watch the video here.

Meaningful Use Measures: Clinical Summaries – Meaningful Use Monday

Posted on June 27, 2011 I Written By

Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money.

Meaningful Use Core Measure: Provide clinical summaries to patients for more than 50% of all office visits within 3 business days.

Exclusion: Any EP who has no office visits during the reporting period.

The clinical summary provides clinical information associated with a specific recent visit. (It does not encompass the entire patient chart.) This measure may appear daunting upon first reading of the requirements, but the guidance below should make it achievable. 

The clinical summary can be delivered by one of two means: electronic media, (e.g., patient portal, secure e-mail, CD or USB fob), or a printed copy. According to advice received from CMS, the easiest way for a physician to meet this measure is to employ a patient portal as the default option. Following each office visit, the EP (or staff) simply uploads the clinical summary to the portal and advises the patient how to access it there. It is only if the patient requests a paper copy that it has to be printed and handed to him or sent by FAX or mail.

Whether the patient accesses the portal or not, the EP will have satisfied the requirement. It is the availability of the clinical summary within the 3-day timeframe—not the patient’s actions—that counts.

As for the content of a clinical summary, the measure defines it to include a comprehensive amount of information, some of which goes beyond the basics typically captured in a digital chart, for example, topics discussed, date of next appointment, tests that should be scheduled with contact information, etc. However, the measure specifications go on to say that to be counted in the numerator of the measure, clinical summaries can be limited to information recorded in the EHR.

Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts.

Microscopic Pictures Through Cell Phones Now Possible Through CellScope

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[blackbirdpie url=”http://twitter.com/#!/mobileactive/status/84330414952554496″]

Yet another amazing technology has been developed because of the desire to improve healthcare in Africa.  This amazing microscope allows a cell phone to take pictures of microscopic images that can then be shared anywhere that has access to the internet.

The idea of medical photo sharing is nothing new as there are multiple apps that provide this service.  What makes this app truly impressive is that it allows doctors to take pictures at the microscopic level that can then be shared across thousands of miles.

In the past it would have been necessary to send the sample across those thousands of miles to get an accurate assessment.  In many cases this is not only difficult but in some cases impossible.  The samples simply cannot last that long.  With the added time and distance it is also incredibly likely for samples to be compromised, or lost all together.

This new development would allow a doctor who stumbles across an outbreak in a small village to get a rapid response as to what may be going on and be able to treat it, or maybe even prevent a greater outbreak.  This could save numerous lives in every country of the world.

It is currently only available on the iPhone but could easily be converted to other platforms in the future.

Did You Know?

Posted on June 26, 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 a great video that does a great job showing how big the world is, how fast technology is growing and a number of amazing perspectives about what’s going on in the world. I’d seen this video a while back, but Wes Kemp just emailed it to me again and it was great to be reminded of the amazing world we’re living in. I hope you’ll enjoy it as well: