EHR and Health IT Consulting
33.3K views | +1 today
Follow
EHR and Health IT Consulting
Technical Doctor's insights and information collated from various sources on EHR selection, EHR implementation, EMR relevance for providers and decision makers
Your new post is loading...
Your new post is loading...
Scoop.it!

Study: ICD-10 Costs for Small Practices Less Than Previously Estimated

Study: ICD-10 Costs for Small Practices Less Than Previously Estimated | EHR and Health IT Consulting | Scoop.it

ICD-10 expenditures for small physician practices will not be as high as previously estimated, according to research from the Professional Association of Health Care Office Management, published recently in the Journal of the American Health Information Management Association.

Researchers polled 276 physician practices with fewer than six providers, with results finding that the practices spent an average of $8,167 on ICD-10 implementation, while individual providers spent an average of $3,430. According to the researchers in this study, there are now three studies documenting that ICD-10 implementation costs in small physician practices are dramatically lower than originally reported in the widely publicized American Medical Association (AMA)-funded study, which estimated the cost for a small practice to implement ICD-10 was in the range of $22,560-$105,506.

Survey respondents were asked to specify the number of providers in the practice where a provider was defined as a direct caregiver, such as physicians, physician assistants, and nurse practitioners. Respondents were asked to specify the total expenditures in the practice for all ICD-10-related activities, including costs already incurred and costs remaining to be expended. The instructions associated with the question on expenditures specifically noted that the costs of obtaining ICD-10 manuals and documentation, ICD-10 training costs, the cost of superbill conversion to ICD-10, and software system upgrades and testing should all be included as ICD-10-related expenditures.

As expected, the expenditures associated with ICD-10 increase as the size of the practice increases, but the per-provider expenditures decrease as the size of the practice increases. The per-provider ICD-10 average expenditures ranged from $4,372 for a practice with a single provider to $1,838 for practice with six providers, the study found. What’s more, on average, the combined amount of ICD-10-related hours expended across all personnel types in practices with six or fewer providers was 45.5 hours per provider in the practice. “Based on this survey and the two other recent studies, the financial barriers to ICD-10 are significantly less than originally projected,” the researchers concluded.


more...
No comment yet.
Scoop.it!

Health System Praises EHR Use After Fire at Paper Record Warehouse

Health System Praises EHR Use After Fire at Paper Record Warehouse | EHR and Health IT Consulting | Scoop.it

A health system spokesperson touted the use of electronic health records to store duplicate copies of patients' medical files after a seven-alarm fire at a document warehouse in Brooklyn, N.Y., this weekend sent charred papers from several medical institutions blowing through the streets, EHR Intelligence reports.

Fire Details

The CitiStorage warehouse -- located on the East River -- was stacked floor to ceiling with archived records, including those from the New York City Health and Hospitals Corporation and members of the Greater New York Hospital Association. 

The blaze -- the first seven-alarm fire in New York City since 2012 -- required more than 60 units and 275 firefighters to contain.

Fire Commissioner Daniel Nigro said no one was hurt in the fire, and the cause of the fire remains under investigation. Authorities have noted that the building was regularly inspected by fire authorities.

Ian Michaels, a spokesperson for HHC, said, "Fortunately, as an early adopter of electronic medical record systems, HHC keeps vital patient records in electronic form and we do not anticipate this will affect our patient-care operations".

According to AP/CBS New York, the fire could take at least a week to put out.

Privacy Concerns

While electronic data breaches are likely more common than warehouse fires, many observers say they are concerned by the private information that the fire has sent blowing into nearby streets.

According to the New York Times, the scattered papers include:

  • Copies of checks containing bank account numbers;
  • Documents marked "confidential";
  • Health insurance forms with Social Security numbers; and
  • Medical reports containing patient names.

Spencer Bergen, a nearby resident, said in an interview with the Times, "They're like treasure maps, but with people's personal information all over them." He reported finding half-charred scraps of documents several blocks from the warehouse.

The city has deployed disaster recovery contractors to collect the documents.


more...
No comment yet.
Scoop.it!

Paper or Electronic – Does Physician Age Matter?

Paper or Electronic – Does Physician Age Matter? | EHR and Health IT Consulting | Scoop.it

My first victims—er—test subjects happened to be my daughter’s pediatrician and a resident on his rotation. Who could ask for a more perfect situation to test this theory? She was a young resident, and he has been a physician since before I was born. I was surprised, therefore, to hear the same complaints about what was wrong with the electronic health record from both and no real answers for what they expected from an EHR. Neither were afraid of technology in and of itself, so I considered that factor controlled. Their complaints? The cut/paste feature allows too many errors through (and they had many real-life examples), alert fatigue, and the narrative portions are too long to scroll through. They get hung up on the mistakes and then decide they can find out more, and more quickly, if they just ask the patient for the information again.

Alright, he actually said he hated it, and she didn’t say that, but that was about the only difference. Ideas for what they’d want instead or how the technology should work? Not so much—from either one.

A trauma surgeon friend at Geisinger Medical Center in Pennsylvania recalled her experiences when they first installed an EHR in her hospital. She hated it. You have never seen such hate as when she recalls her first interactions with the system. She is a vocal sort and, eventually, the hospital said to her that they had an opportunity to customize the system to their hospital and asked if she would serve on the consulting committee. She protested that she knew nothing about computers. They told her they didn’t want somebody who knew about computers. They wanted somebody who had definite opinions about how the system could improve clinical workflow.

My friend said yes. Today, she says she can’t imagine practicing medicine without the EHR. She says it makes her a better doctor. For the record, my friend started out in a paper environment, switched to the EHR, but is not really tech savvy at all.

I checked in again with her recently and asked if she saw any real difference between how older docs and her residents use the system. She said that the older docs use it to get information, and the younger docs do things with it. “That’s the reason for the resident minion,” she says. The older docs get their information from the system and tell the minion to do all the things that have to do with CPOE. She says, “I’d never be able to spell ophthalmology correctly in the system in order to get a consultation!”

She agrees that there is some alert fatigue among physicians, but she thinks it definitely keeps patients safer. She also says it’s often a love/hate relationship for most staff members, but that nobody would willingly practice without it again.

So, is adoption of and satisfaction with an EHR a function of age or technical ability or is it something else?

Perhaps it’s specialty. A pediatrician or a family practice doctor sees many different types of problems, usually has a long history with patients, and may have an electronic record much like the old paper records. I’m sure you’ve seen those thick files, bulging with years’ worth of reports and letters and hand-written charts. It seems that the electronic record, in those cases, may be no better than an electronic form of a paper chart. A trauma surgeon, on the other hand, sees a patient for a short period of time, has less information that requires review, probably makes full use of clinical decision tools but hears very few alerts to make decisions about. The patient is seen, operated on, and discharged to another practice (where they have to slog through the narrative details of the patient’s hospital stay).

More likely, EHR satisfaction is simply a matter of not realizing the advantages we have in front of us because of the difficulties we still focus on. Back when the only option was a paper chart, there were plenty of complaints about those, too. At least we no longer have to deal with doctors’ handwriting (and my friend made the case for me about why doctors have such bad handwriting—they can’t spell—but that’s another story).

Are there problems with EHRs that could still stand some fixing up? Of course there are. But, if you had an honest discussion with yourself about whether you’d prefer going back to paper charts, what would your answer be?

Maybe it’s time to crowdsource solutions instead of complaining about the products as they stand today. What do you expect from your EHR, and how can you be part of the solution? By the way, there is one critical element about people who’ve worked with paper charts and those who haven’t—their expectations and ideas about EHRs are equally important!

What’s been your experience with EHR use and the impact of a physician’s age?


more...
No comment yet.
Scoop.it!

IBM and Epic Prep for Multi Billion Dollar DoD EHR Contract | Hospital EMR and EHR

IBM and Epic Prep for Multi Billion Dollar DoD EHR Contract | Hospital EMR and EHR | EHR and Health IT Consulting | Scoop.it

In this recent Nextgov article, they talk about what Team IBM/Epic are doing to prepare for the massive bid:

On Wednesday, IBM and Epic raised the bar in their bidding strategy, announcing the formation of an advisory group of leading experts in large, successful EHR integrations to advise the companies on how to manage the overhaul — if they should win the contract, of course.

The advisory group’s creation was included as part of IBM and Epic’s bid package, according to Andy Maner, managing partner for IBM’s federal practice.

In a press briefing at IBM’s Washington, D.C., offices, Maner emphasized the importance of soliciting advice and insight from the group. Members of the advisory board include health care organizations, such as the American Medical Informatics Association, Duke University Health System and School of Medicine, Mercy Health, Sentara Healthcare and the Yale-New Haven Hospital.

Add this new advisory group to the report that Epic and IBM set up a DoD hardened Epic implementation environment and you can see how seriously they’re taking their bid. Here’s a short quote from that report:

Epic President Carl Dvorak explained the early move will also help test the performance of an Epic system on a data center and network that meets Defense Information Systems Agency guidelines for security. An IBM spokesperson told FCW that testing on the Epic system has been ongoing since November 2014.

As we noted in our last article, 2015’s going to be an exciting year for EHR as this $11+ billion EHR contract gets handed out. What do you think of Team IBM/Epic’s chances?



more...
No comment yet.