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4 reasons to go virtual for Healthcare IT

4 reasons to go virtual for Healthcare IT | EHR and Health IT Consulting | Scoop.it

First there was the migration to the cloud, now it's a push for virtualization. Gone (or soon to be gone) are the days where every nurse, doctor, and healthcare professional is chained to a desktop PC upon which they rely for access to their software and information.

 

Virtualization and the cloud are not necessarily the same thing. The latter is a remote data warehouse that stores information.

 

The former entails running an application on one computer through a browser on another machine, which could be hundreds of miles away. Imagine accessing a bulky and power-intensive application that normally requires a PC on a tablet. This is just one of many elements of flexibility that virtualization can provide.

 

The top 4 reasons:

 

1. Personalized healthcare applications.

2. Patients outreach.

3. Flexibility.

4. Security.

 

Virtualization and the cloud are not necessarily the same thing.

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Technical Doctor's insights and information collated from various sources on EHR selection, EHR implementation, EMR relevance for providers and decision makers
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Have you hugged your EMR lately?

Have you hugged your EMR lately? | EHR and Health IT Consulting | Scoop.it

Seeking to provide balanced discourse and to recognize marginalized voices at the gooey center of health care, I kindly ask that you find a seat in the Captain’s Room of the Hilltop Motor Lodge for the inaugural meeting of Physicians for the Liberty of the Electronic Health Record, where founder and president Dr. IM Klickhffor starts the proceedings with this plenary talk.

Thank you, thank you. Many of you are using this weekend to catch up on your charting. To raise your hands from the keyboard and clap so generously fills my heart with a JOY template. This weekend wouldn’t be possible without the generosity of the IT companies crowding the exhibit hall, the motel gym, and the less humid corners of the indoor pool. But any conflicts of interest on my part are entangled more with the contradictions that make us human.


Why are we here? I’d argue it’s because medicine is in desperate need of a new orderset, and it’s called EMRpathy. Physicians must value electronic medical records, EMRs, and the larger enterprise of electronic health records, because they possess intrinsic worth. This complex, vulnerable and sensitive software shouldn’t be tolerated for their financial incentives and then insulted for destroying the doctor-patient relationship.


We must stop treating the unexpected screen, dialogue box or pop-up menu as an uninvited guest and instead embrace the opportunity to be questioned by these beneficent and diligent systems. In this way, our colleagues might discover what we’ve known all along — the meaning at the heart of “meaningful use.”


But such radical ideas tug at the roots of precepts that anchor the medical profession, namely the Hippocratic writings. We’ve all been to medical school. We’re familiar with aphorisms such as, “it is more important to know the patient who has the disease than the disease the patient has.” I dare not contradict Hippocrates, but medicine has advanced over the past 2,500 years. An ICD-10 diagnostic code exists for the craziest stuff, like “Spacecraft crash injuring occupant, initial encounter,” but you won’t find a code for restoring the imbalance of the four humors.

No disrespect to Hippocrates, after all, he’s famously the father of western medicine. But when it comes to the challenges in our modern age, he risks appearing as a deadbeat dad.


The most important element in the care of our patients in 2015 is documentation. If we don’t represent the patient in the EMR, the patient doesn’t exist. If not documented appropriately, a skilled and expert physical exam never happened, and intimate conversations with a patient or family become figments of our imaginations. We don’t get paid if the coders can’t play the coding game, and where do they play that game — on the field of the EMR.


The EMR holds the heart, lungs and soul of medicine. In a better world, we wouldn’t need lobbyists to fight for EMRpathy, but my own story speaks to the challenges before us.


My personal journey almost ended at the login page. Ten hours of formal training outside of my hectic clinical schedule, followed by thirty hours on my own time practicing and cursing the system. Like you, I screamed in my sleep, woke up dripping in sweat. I went to a dark place, seriously chewed on the idea of a professional reboot out of clinical medicine, the profession I loved.


But during one ER shift, I asked the EMR representative why most EMRs seemed designed by medical students who graduated last in their class. Why couldn’t the EMR be more user-friendly, intuitive and ready to go out of the box? She listened with unflappable calm, blew a thread of chestnut hair that had drifted over her eye. “Let’s explore,” she said, beaming, and clicked through each busy screen like an astronomer canvassing a night sky. “Take a seat,” she said. “But before logging in, I want you to contemplate the important relationships in your life, your family, and close friends. Were they always smooth sailing? Of course not. If marriage requires work, why wouldn’t your relationship with the EMR, who you’ll be spending more time with than your wife, be any different?”


“But isn’t empathy with the user a fundamental principle of design thinking?” I said. “Because I don’t feel the love.”

“Didn’t Hippocrates say the patient comes first?” she said.

“But this system doesn’t put the patient first, either.”

“It puts their chart first,” she said. “If Hippocrates had to document on his patients, he wouldn’t have had time to write what he did.”

That revelation struck me in the head like a dropdown menu. Resentment won’t make the EMR better, only patience and EMRpathy.  Imagine Hippocrates working as an ER physician in 2015. He would be stomping around the trauma room in clogs, grumbling and scratching under the collar of his scrub top. Why? His Press Ganey surveys were riddled with patient comments about his sandals and tunic.


Physicians complain about the utility of such patient satisfaction scores, especially when it’s tied to their reimbursement, and I must confess that I agree with them on this point. Does it make sense to evaluate and compensate physicians on our interactions with patients when medical practice is now about the Doctor-EMR relationship? Studies show that ER physicians spend twice as much time with the EMR than with their patients, and that’s high touch intimacy, with over 4,000 mouse clicks in a busy 10-hour shift. Who touches patients 4,000 times in a shift?


Physicians lament how EMRs keep them away from the bedside of their patients. But the bedside is vanishing, too. Through telemedicine, patients  exist on the screen, not sitting on a stretcher before us. No bedside to sit at. Nobody to examine. And with no body to examine, we point to the physical exam, and it looks very different. Despite the evolving state of the clinical encounter — bedside or screen — our patients’ digital symptoms are seamlessly melded with orders and decision-making and preserved as one in the EMR.


Hippocrates still breathes, only it’s Hippocrates 2.0. We’re creating a digital life. Physicians must turn their gaze to the EMR with eyes wide open and appreciate the EMR as another respected colleague.

Corporations are considered people, so why not EMRs? The EMRpathy orderset asks physicians to be sensitive to the EMR’s feelings and point of view. Medical schools must recognize EMR disparities and develop curricula in EMR cultural competency. Reading literature that ventures beyond the people-centric canon would mark a solid first step in changing the culture. It will take time. But if we teach and champion effectively, the next generation of physicians won’t flinch at each honk and hard stop, or respond rudely to the dialogue boxes insisting on conversation. They’ll accept documentation as a quest. They’ll understand that our response to obstacles defines our character as individuals and physicians.


What can you do right now? Acknowledge our keyboard intimacy, that our fingertips know the personality of each key better than it ever recognized an enlarged spleen or an S3 heart sound. Tenderly welcome each click and greet each drop down menu as an invitation for friendship. Slow down and click. And click again. And click some more. Be present in the moment, these endless moments of great meaning.


I’m happy to take questions. But if you want to take the next ten minutes to catch up on the charts, honor them with my blessing.

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Diabetes Registries under Meaningful Use Objectives Boost Care

Diabetes Registries under Meaningful Use Objectives Boost Care | EHR and Health IT Consulting | Scoop.it

Meaningful use objectives have brought about a significant push toward improving the quality of patient care as well as population health outcomes. The Medicare and Medicaid EHR Incentive Programs cover a wide variety of medical care processes including physician EHR use, electronic prescribing of medication, and public health reporting.


A team of researchers analyzed whether using diabetes registries to meet meaningful use objectives among primary care providers actually led to a variance in healthcare quality and rates of hospital utilization, according to the Journal of the American Medical Informatics Association (JAMIA).


The researchers conducted a practice assessment poll to find out how primary care practices were utilizing diabetes registries. The study looked at insurance claims data from five years ago and compared health outcomes in patients who were treated at facilities using diabetes registries to meet meaningful use objectives against the patient outcomes from other medical care settings.


The research team used logistic hierarchical linear modeling to study the data. The analysis covered more than 12,000 diabetic patients among 50 primary care practices. Type 2 diabetes patients who were treated in facilities with diabetes registries were given scheduled reminders had a higher rate of recommended laboratory testing and dilated retinal exams.


Type 2 diabetes patients who received regular reminders through diabetes registries had less likelihood of avoidable hospitalizations as well as emergency department visits. While Type 2 Diabetes patients saw improvements due to the meaningful use objectives requiring a registry, Type 1 diabetes patients did not see any significant implications due to the use of a registry.


The study concludes that healthcare providers who meet meaningful use objectives by using diabetes registries does, in fact, lead to lower hospitalization rates and higher likelihood of completing recommended lab tests among Type 2 diabetes patients.


Along with utilizing diabetes registries, digital health solutions for tracking health and wellness could also impact chronic disease management. Tactio and Influence Health have come together to offer effective health technologies that utilizes EHR data from multiple systems to help patients and caregivers monitor and track disease progression like diabetes along with utilizing a patient portal to better communicate with providers regarding an appropriate treatment plan.

“With Influence Health and Tactio, patients can track their health on their iPhone, iPad and Android devices. They can receive the coaching and education to live healthier lifestyles and better control chronic diseases such as obesity, hypertension, diabetes, atherosclerosis and COPD,” Michel Nadeau, P.Eng., President, CEO and Founder of the Tactio Health Group, said in a company press release. “Additionally, with consistent branding across an organization’s website, patient portal and mobile health apps, patients are able to access the healthcare organization they trust – anytime, from anywhere.”


These tools will help patients track their weight, blood pressure, and physical fitness metrics. Such technologies may lead to better chronic disease management and improved population health outcomes across the country.


“Partnering with Tactio provides an additional layer of information expanding capabilities and helping healthcare organizations strengthen patient participation in their health,” stated Bradley Case, GM/SVP, Clinical Solutions of Influence Health.

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How An EHR Makes A World Of Difference - EHR News & Industry Resources

How An EHR Makes A World Of Difference - EHR News & Industry Resources | EHR and Health IT Consulting | Scoop.it
Imagine, sometime in the future, how great it will be when every doctor and patient will be using the power and convenience of the mobile EHR (and for you doc’s out there, imagine a mobile EHR that is simple, effective, and easy to use – but I digress).  I bring this up, because while on vacation in Hawaii a few years ago, I fell and was dragged on a reef that did some not so great things to my back as you might imagine.  Well, I was lucky enough to be near a fairly large clinic to get stitched up, but that is where the convenience factor ended. After filling out form after form in their waiting room, I was finally taken care of.  I know I’m offering just the patient’s point of view here, but the customer experience really is what is defining success for businesses – everyone knows it, right? So, let me paint the picture of going through a traumatic experience without the benefit of an EHR system.
 
I can’t think of anything more ridiculous than expecting someone who can barely move to fill out a full medical history, let alone being able to actually remember what medications they’re allergic to.  I can’t even remember my medication allergies on a good day to be honest with you.   During this process, it was all I could do to push through the burning pain I felt on my back and I worried if my wounds were infected, and how many stitches I would need. There had to be a better way to be taken care of – the whole waiting and filling out forms thing felt like torture and certainly not the way I’d imagined spending my vacation.
After filling out various, repetitive forms about family medical history (Most of which didn’t seem applicable to my current situation – Come on, why would my father’s history of diabetes affect my back being stitched up?) I was finally admitted and stitched up.  The actual stitching up process took less than 30 minutes.  In total, I spent over three hours trapped inside of the clinic.  I don’t know about you, but I went to Hawaii to enjoy the beaches, not the emergency clinics.
Maybe its just because I am exposed to products like drchrono, but looking back on this helpless, frustrating situation, I couldn’t help but imagine how greatly improved my experience as a patient would have been if this clinic would have utilized ANY sort of an EHR.  drchrono’s EHR offers simplistic, customizable, and intuitive design and holistic functionality for physicians to offer the ultimate patient experience.  By utilizing drchrono’s EHR, this clinic would have been able to onboard me with a few taps on an iPad instead of having me manually write out answers on forms (much more preferable of an action for someone in so much pain – and quicker too!). Additionally, if referral information was required that would have been easily accessible as well.
If you’re interested in providing the ultimate patient experience, consider the right tools to enable your practice to deliver that. drchrono’s EHR solution specializes in giving you access to the services and information you need to provide the highest quality care – don’t let processes and mechanics get in the way of your success – make every interaction you have with your patients an opportunity to educate, inspire, and build a connection towards better health.
For those of you vacationing near the beach this summer – watch out for the reefs!
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Increasing Productivity with Your EHR: 5 Strategies

Increasing Productivity with Your EHR: 5 Strategies | EHR and Health IT Consulting | Scoop.it

With the passage of the HITECH Act in 2009, the federal government began requiring physicians to adopt EHR technology. The act mandates "meaningful use" of EHRs by providing incentivized Medicare and Medicaid payments to physicians who use the technology and imposing Medicare penalties on non-adopters. Since then, physicians have voiced concern about decreased productivity and revenue with EHR implementation.


Study results have been mixed, with some studies showing decreased productivity and others showing stable or increased productivity after implementation. Given these inconsistent results, it's reasonable to conclude that success varies among practices with respect to EHR adoption.


So how do you implement an EHR and maintain or improve your productivity? Here are five strategies to consider.


1. Provide Quality Training


Some people in your practice may be technical whizzes. Most are probably not and will require in-depth training to begin feeling comfortable and efficient using an EHR. Successful training requires an initial assessment of physician and staff computer skills, several days of individualized in-house training, as well as ongoing feedback sessions and tutorials. One training technique that has been shown to be effective is to create peer "super users" within the practice who can help others get up to speed with the new system.


2. Delegate Tasks to Your Staff


The work flow of your practice will change as you adapt to using an EHR. One way to improve the new work flow and increase efficiency is to delegate certain data entry tasks to support staff. You can enable medical assistants and nurses to enter vital signs, social and family histories, problem lists, and medical reconciliation into the electronic chart. You can even grant certain staff the ability to enter orders that are later electronically co-signed by you. Each task you delegate is less time that you spend at the computer and more time available for your patients.


3. Customize Your EHR


Do you like your notes and charts formatted a certain way? Do you order certain tests frequently? Almost all EHRs allow for customizable templates as well as ways to create lists of "favorite" or frequently used orders and order sets. Customizing your EHR can significantly decrease the number of "clicks" you need to make for each patient encounter.


4. Decrease Your Typing


For years, physicians used paper charts and transcription services, so it's not surprising many of them feel that typing slows them down. Consider working with a medical scribe who not only is a speedy typist but who is also trained in medical terminology as well as effective and thorough charting. If hiring a scribe seems like it would be too much of an expense, consider purchasing voice recognition software to decrease your burden of typing and boost your productivity.


5. Implement a Patient Portal


Patient portals are convenient for your patients because they allow people access to their health information online. But patient portals can also be convenient for your practice and can even improve your office's efficiency. Ask your patients to fill out new health information, issues, and concerns from home a day to two before coming in to see you, thus allowing you to have access to patient questions in advance and to save time during appointments. Encourage patients to use the portal to request and "pick up" prescription refills, referrals, and lab test orders, as well as to schedule office visits — all of which will free up your support staff to attend to other duties.


Since the passage of the HITECH Act, medical practices have been mandated to adopt EHRs. While the transition to new EHR technology can be challenging, various strategies can be used to enable a practice to quickly increase productivity and revenue.

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At AMDIS, AMIA’s Fridsma Promotes the Rethinking of MD Documentation for EHR Usability

At AMDIS, AMIA’s Fridsma Promotes the Rethinking of MD Documentation for EHR Usability | EHR and Health IT Consulting | Scoop.it

On June 24, Doug Fridsma, M.D., Ph.D., in a presentation to the AMDIS Physician-Computer Connection Symposium being held at the Ojai Valley Inn and Spa in Ojai, Calif., shared with CMIO attendees some of the latest activity going on with regard to the American Medical Informatics Association (AMIA), the association of which Fridsma became president and CEO last fall, after having served as chief science officer in the Office of the National Coordinator for Health IT.


Fridsma shared with his CMIO colleagues some of the highlights of the recently released “Report of the AMIA EHR 2020 Task Force on the Status and Future Direction of EHRs,” referred to in shorthand as “EHR 2020.”


As part of the opening of that report, published online on May 29 in the Journal of AMIA (JAMIA), notes, “Over the last five years, stimulated by the changing healthcare environment and the HITECH Meaningful Use (MU) EHR Incentive program, EHR adoption has grown remarkably, and there is early evidence of benefits in safety and quality as a result. However, with this broad adoption many clinicians are voicing concerns that EHR use has had unintended clinical consequences, including reduced time for patient-clinician interaction, transferred new and burdensome data entry tasks to front-line clinicians, and lengthened workdays.” Further, the report’s introduction stated that “Interoperability between different EHR systems has languished despite large efforts. These frustrations are contributing to a decreased satisfaction with professional work life. In professional journals, press reports, on wards and in clinics, we have heard of the difficulties that the transition to EHRs has created.”


With regard to the way forward, the authors of the report said in their introduction, “Ultimately, our goal is to create a robust, integrated, inter-operable health system that includes patients, physician practices, public health and population management, and support for clinical and basic sciences research. EHRs are an important part of this ecosystem, along with many other clinical systems, but future ways in which information is transformed into knowledge will likely require all parts of the ecosystem working together. This ecosystem has been referred to as the ‘learning health system.’”


What’s more, the report’s authors noted, “Potentially every patient encounter could present an opportunity for patients and clinicians alike to contribute to our understanding of health care and participate in research and clinical trials. As part of the learning health system, EHRs have long been touted as beneficial to the safety and quality of health care, and studies have shown potential benefits related to information accessibility, decision support, medication safety, test result management, and many other areas. However, implementation of any new technology leads to new risks and unintended consequences; these too have been well documented.”


Speaking of the release of “EHR 2020,” Fridsma told the AMDIS audience on Wednesday that Senator Lamar Alexander, chair of the Senate HELP Committee, “was running around at Vanderbilt, saying, ‘This is something that addresses a lot of the concerns we have.’”

Fridsma noted in his comments that the effort that led to the “EHR 2020” report predated his tenure at AMIA, but reflects the broad focus of the association at this point in time. “We brought together experts to say, what will the EHR look like in the next few years, and what kinds of things could we discuss? And then the Senat HELP Committee testimony that occurred ten days after this was done” created results. “Lamar Alexander took the five principles and said, ‘I’m going to have five hearings on those principles.’” And that, Fridsma said, is what is expected to happen.


Fridsma summarized the learnings shared in the report by noting four main areas of focus. “The first thing we had in the report,” he said, “was that we need to simplify documentation. We went through a series of discussions on why documentation is so complex. We are accelerating to the next stage, but we’re not necessarily getting to the end goal. So we create a whole series of activities” around physician documentation, as a health system, he said, “one set around what is required by regulation, and the other necessary for patient care. Some of this is tied to how our reimbursement works. But the most important development at ONC was the CMS [Centers for Medicare & Medicaid Services] targets for alternative payment models, because that gives physicians and other providers financial incentives to move forward in this area. That will be more of an incentive than Stage 3 of meaningful use, which was really front-loaded.”


The other areas of focus of the report were the need to make regulation more focused; the need to increase transparency around EHR functions; and the need to encourage innovation. As for encouraging innovation, Fridsma told his audience, “That really speaks to a lot of the work going on at ONC right now around FHIR, etc. We’re moving from document-centered ways of viewing information to data-centered ways of viewing information. The EHRs we are using today are not the EHRs that the people we are training today are going to be using. And the way we’ll get there is to encourage APIs and other solutions.”


And he added that, with regard to the report, “We said, if you’re going to focus regulation and increase transparency and encourage attempts to simplify documentation, make sure to keep your patient at the center, as the North Star.” He added that “Our plan is to pick themes like these over the next year, and to focus on those themes” at AMIA, in a strategic way intended to help guide healthcare industry thinking on EHR development and evolution.

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From data to EHRs, clinician offers 'modest technology agenda'

From data to EHRs, clinician offers 'modest technology agenda' | EHR and Health IT Consulting | Scoop.it

While big data, electronic health records and patient engagement tools are seen as the big solutions to improving healthcare, there are more modest goals clinicians eye to provide better care, says Gurpreet Dhaliwal, a staff physician at the San Francisco VA Medical Center.

Gurpreet, in a post for the Wall Street Journal, offers a "modest technology agenda" that he, as a front-line clinician, hopes to use to do his job better. The agenda includes:


  • Using good data, instead of just big data. Massive data sets don't often help to change a practice, he writes. What clinicians need is constant access to study findings; synopses that have already been confirmed and scrutinized. In May, Jason McNamara, the Centers for Medicare & Medicaid Services senior technical director of Medicaid health IT, said the industry needs to "keep challenging the data, keep asking questions."
  • When it comes to electronic health records, the tools need to be used not just for documentation and billing, but also to help clinicians learn, Gurpreet says. EHRs should make it easy for doctors to answer quick questions about how their patients are doing, as well as to schedule reminder emails about notes and labs for specific patients.
  • Getting updates from patients should be as easy as sending an email or setting up a videoconference, Gurpreet adds. There is "the outdated emphasis on face-to-face visits," he says, and electronic communication makes it easy to see patients more often.


"It is more important to be connected to your healthcare provider than it is to be connected to your Fitbit," he writes.

One healthcare provider, Cleveland Clinic, is taking the promise of telemedicine in stride. The health system is working on the deployment of a telemedicine service tapping mobile devices to provide patients a virtual consultation within minutes.


In addition, from clinicians like Gurpreet to nurses and other providers, roles in the healthcare industry are changing because of technology and these changes require that all players become tech-savvy.

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A better road to information interoperability?

A better road to information interoperability? | EHR and Health IT Consulting | Scoop.it

In the national discourse about interoperability, much of the focus is on enabling a doctor using one electronic health record to access patient information residing in a different hospital’s EHR, even when another vendor built it.


But is that really the best way to give doctors the data they need?

"Having the government mandate interoperability is completely wrong," JaeLynn Williams, president of 3M Health Information Systems, told me. "I think we should let the market drive it – and the market says physicians want a single workflow."


That workflow does not have to be directly in an electronic health record, either, and in all likelihood it won't be as the industry moves beyond its initial digitization and into what many are hailing as the post-EHR era, wherein new platforms come to market that enable clinicians to more effectively follow their patients.


If you picture the EHR as one piece of a software stack, rather than the entire application, these technologies are a layer of abstraction above the EHR and essentially reach down to get that data.


"That's what clinicians want. They don't care about interoperability," said Stuart Hochron, MD, chief medical officer at mobile collaboration platform maker Practice Unite. "They want the information."

Eclectic collective

I'm going to group a bunch of tools together, for simplicity's sake, and christen them as part of a new breed of software delivering that patient data. 


Practice Unite and 3M, with its workflow tools, are in there. Others include par8o, with its boldly-marketed "operating system for the entire healthcare industry," ExamMed's newly-minted "universal healthcare technology platform" and the TapCloud smartphone app, which the company calls "a powerful overlay to an EHR."


Overlay. That's the operative word and, indeed, while ExamMed and par8o are more about reaching and tracking patients they also, for lack of a better term, overlay EHRs and other software systems.

It's important to explain that, rather than being direct competitors, these vendors are a representation of emerging technologies that more closely tie clinicians with patients in a way where all parties have access to relevant data. Hospitals could implement and use two or more of them. And they are just a few of the countless innovators coming to market.


Make no mistake: None of these are going to take over the world and solve today's existing interoperability issues alone. Instead, what they have the potential to do is create pockets of interoperability that might not get us to the Holy Grail of any doctor being able to see all the records of any patient – but might land us somewhere close enough. 


Take par8o, for instance. Lancaster Regional Medical Center is using the platform on top of multiple vendors' EHRs from triage to tracking patients' next steps in care outside its own facilities, according to Lancaster Regional CEO Russell Baxley, to essentially tie together various providers in the area with specialists, patients and payers. Other par8o customers such as MGM Resorts and Mt. Sinai in New York also have the potential to enable wide regions of information interoperability.

An industry misguided?

The Office of the National Coordinator for Health IT is at the epicenter of all this. Its 10-year roadmap to interoperability ambitiously aims for the end point of a learning health system – which is, in my opinion, a noble goal and one worthy of the federal government's efforts.

  

But not everyone will agree with me on that, of course. When I asked Williams if she thinks that the government should back off its efforts to drive standards that fuel interoperability, she cut to the chase: "I would say 'yes.' We're relying too much on standards."

Baxley didn't pull punches either.


"I think we played it out all wrong to get to where we need to be. There's nothing pushing anybody toward true interoperability," he said. "The incentives and the penalties are placed on the wrong people. The only way we'll have true interoperability is when the penalties are placed on the EHR providers and bonuses offered for those vendors to make their systems interoperable."

Inching closer

This new crop of platforms won't supplant ONC's work, of course, but they could soar right on by.


"The ability to capture data selectively and share it opportunistically in ways that empower the clinician will surpass any plans to create huge data warehouses and EHR-to-EHR interoperability," predicted par8o co-founder Adam Sharp, MD. 


Indeed, as more and more pockets of interoperability expand outward, we inch ever closer to that broad-accessibility of data that so-called interoperability promises. But will that be close enough to nationwide interoperability to affect the care delivery improvements we all want?

"I think regions are good enough," 3M's Williams said. "We have pieces of interoperability that exist right now. I believe that we are a lot closer than we think."

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Lack of Certified EHR Technology in ASCs Fixed by Congress

Lack of Certified EHR Technology in ASCs Fixed by Congress | EHR and Health IT Consulting | Scoop.it

Previously, meaningful use requirements made it difficult for healthcare providers to receive financial incentives from the Medicare and Medicaid HER Incentive Programs if they send their patients to ambulatory surgery centers (ASCs). Since ASCs do not have certified EHR technology, it was not possible for providers to obtain these incentives.


However, the Electronic Health Fairness Act has changed these issues, as it has averted the need for services performed in ASCs to be counted toward the 50 percent patient encounters threshold under meaningful use requirements until the Office of the National Coordinator for Health IT (ONC) develops certified EHR technology for this particular segment of healthcare settings, according to the HIMSS website.


“The Electronic Health Fairness Act of 2015 (H.R. 887/S. 1347), introduced by US Representatives Diane Black (R-TN) and David Scott (D-GA), would exempt patient encounters performed in an ASC from being counted toward meaningful use of EHRs until such time as a CEHRT exists for the ASC setting,” theAmbulatory Surgery Center Association stated. “The legislation would also authorize the US Department of Health and Human Services (HHS) to certify an EHR system for ASCs.”


Republican Senator Johnny Isakson (R-GA) and Senator Michael Bennett (D-CO) both brought the S. 1347 bill forward. Additionally, Congresswoman Diane Black (R-TN-06) and Congressman Earl Blumenauer (D-OR-03) authored the H.R. 2570, the Strengthening Medicare Advantage through Innovation and Transparency for Seniors Act. This particular bill includes language referencing the Electronic Health Fairness Act. The bill was passed by the House of Representatives.


“One third of Medicare beneficiaries in Tennessee are enrolled in a Medicare Advantage (MA) plan. Seniors in my district consistently tell me that they enjoy the flexibility and choice of MA. I’m proud that the House acted today to strengthen this important program both for current beneficiaries and future retirees – and we did it in a bipartisan way that puts patients and their doctors first,” said Congresswoman Diane Black in a public statement. “Our seniors deserve access to health coverage specifically tailored to their needs and dedicated to their unique health and well-being. With the passage of these bills, we have taken an important step forward in achieving that goal.”


As previously reported by EHRIntelligence.com, Dr. Scott Ketover, the President and Chairman of the Board of Digestive Health Physicians Association (DHPA) and the President and CEO ofMinnesota Gastroenterology, finds that healthcare providers were more likely to transfer their patients to more expensive hospital settings in order to keep their meaningful use financial incentives instead of lower cost, more effective ambulatory surgery centers. The Electronic Health Fairness Act, however, prevents this issue from occurring.


Additionally, this new bill will allow “technology to catch up with the legislative requirements,” according to Dr. Ketover. As time marches forward and healthcare tools evolve, ASCs will likely adopt new certified EHR technology under ONC’s certification objectives.

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4 Signs Your Agency Needs EHR Software

4 Signs Your Agency Needs EHR Software | EHR and Health IT Consulting | Scoop.it

Tens years ago, electronic health records seemed like a luxury for medical practices, but today, making the leap to EHR is more of a necessity. Healthcare reform is changing the way the medical community does business and switching to digital records is part of the process. The first generation of EHR software was problematic and cumbersome, but the modern versions offer real advantages to both patients and staff. Consider four reasons it is past time to get EHR software.

1. Inefficient Audit Trails

Whether you are attesting for meaningful use incentives and Medicare payments or going through a routine accounting audit, proper EHR software makes the process that much cleaner. Without EHR, there is no possibility of getting federal incentives, but the auditing benefits do not stop there.


Electronic record systems automate everything from billing to scheduling to general accounting processes. This means more accurate billing with proper coding – with ICD-10 on the horizon, coding will only get more complex, too. When tax time comes around, you have all the documentation necessary to file effortlessly.


EHR opens the lines of communication with insurance companies and federal agencies. When filing a claim or facing a request for repayment, you have a digital record necessary to prove your case.

2. Poor Productivity

EHR software is critical to improving staff performance, as well as the patient’s view of the medical service. A national survey of doctors found that after implementing EHR:

  • The practice functioned more efficiently
  • They could improve staff and stakeholder recruiting
  • It fostered better patient relationships


The little things like not having to hand write notes or prescriptions add up to more time with patients.


EHR improves scheduling by linking appointments directly to patient records and creates communication shortcuts for labs and consultations. Essentially, the workflow of the practice was better with electronic health records.

3. Wasted Space

Physical record storage wastes space that could be used for more practical and revenue-generating purposes. With EHR, you eliminate the need for paper records, opening up that storage area for new exam rooms, imaging equipment or to add another specialty to the practice.


With EHR, physicians can access patient information remotely, as well, making telemedicine a practical option. A doctor is available to answer staff or patient questions whether standing in line at the grocery store or doing rounds at the hospital, because he or she can see the patient records outside of the central storage area. That type of flexibility translates to better patient service and care.

4. Excessive Operating Expenses

An EHR system adds to the bottom line. Paper-driven systems are labor intensive. With the implementation of electronic health records, the agency no longer needs to pay filing clerks to pull and store charts, for example. There is no need to purchase or maintain elaborate retention and retrieval systems.


Other cost saving benefits of EHR include:


  • Reduced transcription costs – physicians and staff do updates as they go instead of dictating notes to be transcribed later
  • Improved reimbursements due to more accurate coding and better documentation
  • Lower risk of medical errors due to missing chart information – with a paper chart critical information like allergies can be misfiled
  • Enhanced wellness care and patient education opportunities – this is especially critical with the new healthcare reform practices focusing on quality not quantity. Practices are not getting paid for services rendered anymore, but for better patient outcomes. This is a factor for patients with chronic illnesses like heart disease or diabetes.


What does EHR bring to the table? Efficiency, productivity, better patient care and cost savings – all essential for agency success.

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Top things providers need to know about interoperability

Top things providers need to know about interoperability | EHR and Health IT Consulting | Scoop.it

It seems that interoperability is the biggest buzzword in health IT right now, and for good reason. Too much money is lost by both providers and patients due to a lack of data sharing and communication between doctors. However, with optimized medical software and implementation and standards outlined by the meaningful use program, nationwide interoperability is a goal that could actually be met in U.S. health care over the next few years.


If you're unsure about what interoperability means, or want to know how you can bring data sharing to your health system, here are some of the top facts you'll need to know:


"The U.S. could save around $30 billion annually with interoperability."


Interoperability saves big


According to an analysis by the West Health Institute, the U.S. health care system has the potential to save more than $30 billion each year with an interoperable platform. Having an electronic health record that travels with the patient not only prevents readmissions and duplicate treatments, but it also saves precious time and resources.


Congress is interested in interoperability


Another story making headlines is interoperability on Capitol Hill. For the past several months, Congress has been taking a serious look at interoperability and the way that organizations and legislation can work together to make this happen.


Cloud computing is driving interoperability


Medical devices are growing increasingly sophisticated in the health care environment, and doctors are relying on smartphones and tablets for diagnoses and treatments more than ever before. In busy medical settings, having cloud access to patient information alongside interoperable systems could make these clinical tasks even easier.


Experts have broken down five main use cases for interoperability


According to a recent study published in the Journal of the American Medical Informatics Association, there are five main use cases that make up an interoperable EHR. They are as follows:

1. Organizations must be able to extract patient data while still maintaining their own structured data.

2. Users must have the ability to transmit the entirety of a patient's EHR, or portions of the EHR, to another doctor.

3. The organization's health information exchange can receive requests for copies of a patient's EHR from providers outside of their system in a standard format.

4. Providers must have the ability to move all patient data from an old EHR into a new EHR.

5. Organizations must have the tools to embed EHR data into a health care system's operating API. This increases the value of data capture and transmission.


The ONC's Interoperability Roadmap is a broad vision


Perhaps the biggest revelation about interoperability is the Office of the National Coordinator for Health Information Technology's Interoperability Roadmap, which outlines a long-term, 10-year plan for the future of interoperability in the U.S. Not only does the roadmap address barriers to interoperability, but it also shows how optimized EHR systems can push interoperability toward patient-centered care over the next decade.


Organizations pushing for interoperability


There are several leading nonprofits you might want to be aware of that are making interoperability a priority, according to Becker's Hospital Review. Some of these include the Argonaut Project, IHE USA (which is partly responsible for ConCert, an interoperability testing program), JASON (a group of independent scientists that advises lawmakers and other government officials about health IT) and the CommonWell Health Alliance. Many of these stakeholders are some of the most influential in health IT, so it's clear that interoperability is a major goal moving forward.


As interoperability becomes more of a focus in health care, providers need to think about ways that they can promote data sharing and health information exchange. With Intelligent Medical Software, clinicians can worry less about whether the health data is accurate on the EHR, and can instead focus more on their patients and save resources.

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Do Meaningful Use Requirements Need the 5% Objective Back?

Do Meaningful Use Requirements Need the 5% Objective Back? | EHR and Health IT Consulting | Scoop.it

Ever since the proposed modifications to Stage 2 Meaningful Use requirements were announced, a wide variety of opinions and objections surfaced throughout the healthcare industry. For instance, patient engagement advocates are calling for a Data Independence Day. Other medical societies are sending forward their comments about both the proposed Stage 3 Meaningful Use requirements as well as the potential modifications to Stage 2.


HIMSS is one organization that supports some aspects that the Centers for Medicare & Medicaid Services (CMS) is pushing forward in the latest proposals for Stage 3 Meaningful Use requirements. For instance, reducing redundant reporting is very beneficial for the healthcare industry, according to a letter HIMSS representatives sent forward to CMS.


For example, HIMSS is supportive of the new 2015 Stage 2 Meaningful Use change to a 90-day reporting period. However, HIMSS is also looking to encourage CMS to develop a phased-in approach to meeting the Patient Electronic Access objectives under meaningful use requirements.


“HIMSS recommends a balanced approach for meeting this objective that recognizes the challenges that some providers are encountering as they try to get their patient population more engaged on viewing, downloading, or transmitting their information to a third party,” the letter stated. “As a part of this approach, given the tight timeline between the publication of this Final Rule and the end of calendar year 2015, CMS could leave the proposed measures in place for 2015, and then phase-in increased threshold requirements for 2016 and 2017, increasing each 1%, 2% to 3% per year to propel the field forward... Overall, HIMSS believes a phased-in approach for the patient electronic access objective to be an appropriate and balanced step forward.”


The Consumer Partnership for eHealth (CPeH), the Consumer-Purchaser Alliance (C-P Alliance), and other organizations sent a letter to CMS expressing their concern over a specific modification on patient engagement objectives under Stage 2 Meaningful Use requirements. Now that CMS intends to only have one patient view, download, and transmit their information under Stage 2 Meaningful Use, many organizations are pushing for bringing back the prior 5 percent requirement.


“CPeH, C-P Alliance, and the undersigned organizations and individuals are dismayed that CMS intends no longer to require that five percent of patients1 view, download or transmit their health information or send a secure message to their providers,” The letter from the Consumer Partnership for eHealth states. “Instead, CMS proposes that doctors and hospitals merely show that just one patient used online access to their health information, and that secure messaging was merely turned on, not whether any patient has actually used it. We are deeply disappointed in CMS’s reversal of these essential commitments to patient and family engagement.”


Healthcare providers should be able to meet the 5 percent requirement and better engage patients with their medical information, according to the letter. Additionally, prior analysis shows that this should be achievable, which is why the new CMS modification is causing such an uproar in the medical community. Research shows that more than half of patients want to be able to email their healthcare provider, which is why the secure messaging aspect of a patient portal should increase patient engagement if properly leveraged. CMS would be wise to take these comments under advisement as they continue to develop meaningful use requirements.

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Some Methods For Improving EMR Alerts

Some Methods For Improving EMR Alerts | EHR and Health IT Consulting | Scoop.it

A new study appearing in the Journal of the American Medical Informatics Association has made some points that may turn out to be helpful in designing those pesky but helpful alerts for clinicians.


Making alerts useful and appropriate is no small matter. As we reported on a couple of years ago, even then EMR alert fatigue has become a major source of possible medical errors. In fact, a Pediatrics study published around that time found that clinicians were ignoring or overriding many alerts in an effort to stay focused.


Despite warnings from researchers and important industry voices like The Joint Commission, little has changed since then. But the issue can’t be ignored forever, as it’s a car crash waiting to happen.


The JAMIA study may offer some help, however. While it focuses on making drug-drug interaction warnings more usable, the principles it offers can serve as a model for designing other alerts as well.


For what it’s worth, the strategies I’m about to present came from a DDI Clinical Decision Support conference attended by experts from ONC, health IT vendors, academia and healthcare organizations.


While the experts offered several recommendations applying specifically to DDI alerts, their suggestions for presenting such alerts seem to apply to a wide range of notifications available across virtually all EMRs. These suggestions include:


  • Consistent use of color and visual cues: Like road signs, alerts should come in a limited and predictable variety of colors and styles, and use only color and symbols for which the meaning is clear to all clinicians.
  • Consistent use of terminology and brevity: Alerts should be consistently phrased and use the same terms across platforms. They should also be presented concisely, with minimal text, allowing for larger font sizes to improve readability.
  • Avoid interruptions wherever possible:  Rather than freezing clinician workflow over actions already taken, save interruptive alerts that require action to proceed for the most serious situation. The system should proactively guide decisions to safer alernatives, taking away the need for interruption.


The research also offers input on where and when to display alerts.

Where to display alert information:  The most critical information should be displayed on the alert’s top-level screen, with links to evidence — rather than long text — to back up the alert justification.


When to display alerts: The group concluded that alerts should be displayed at the point when a decision is being made, rather than jumping on the physician later.


The paper offers a great deal of additional information, and if you’re at all involved in addressing alerting issues or designing the alerts I strongly suggest you review the entire paper.


But even the excerpts above offer a lot to consider. If most alerts met these usability and presentation standards, they might offer more value to clinicians and greater safety to patients.

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Four Medical Practice Embezzlement Red Flags

Four Medical Practice Embezzlement Red Flags | EHR and Health IT Consulting | Scoop.it

Keep an eye out for these red flags for possible embezzlement at your medical practice:

• Carl Frost, founder of Frost & Co., a healthcare consulting and accounting firm, advises physicians to keep an eye on the office manager who writes all the checks and makes all the deposits, in addition to other factors. "Collections aren't on an automated billing system. The same manager [who] handles all payroll functions and has a home computer for doing work from home," is a recipe for trouble, he says. "I've never had a client practice that had all those things going on and not been the victim of embezzlement."


• If your billing staffer refuses to take a vacation, be aware that this is a common trait among employees who embezzle, experts say. Insist on a vacation, and use the time to check over the employee's work.


• Watch and listen to your employees on a daily basis. Pay attention to sudden displays of wealth or, conversely, admissions about major financial setbacks, such as a spouse losing a job.


• Staffers who recommend friends or family for jobs in the practice. Though some companies actually encourage staff referrals, many practice experts say it's a bad idea because the pair could work together to embezzle, or because one relative might be reluctant to turn in another.

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CHIME Highlights Need to Improve Certified EHR Technology

CHIME Highlights Need to Improve Certified EHR Technology | EHR and Health IT Consulting | Scoop.it

The College of Healthcare Information Management Executives (CHIME) has shared a handful of recommendations with the Senate Committee on Health, Education, Labor and Pensions with the purpose of realizing the potential of certified EHR technology to improve patient care.


The organization's letter to the Senate HELP Health IT Working Group outlines challenges and solutions for five use cases, the first centering on improving care quality and patient safety.


According to CHIME, the "most significant challenge" is the lack of a unique patient identifier:


"As our healthcare system begins to realize the innately transformational capabilities of health IT, moving toward nationwide health information exchange, this essential core functionality – consistency in patient identity matching – must be addressed," the letter states. "As data exchange increases among providers, patient data matching errors and mismatches will become exponentially more problematic and dangerous."


The organization is asking Congress to remove a prohibition preventing federal funds from going toward the development of a unique patient identifier. "Robust information exchange and nationwide interoperability can flourish only once we can confidently identify a patient across providers, locations and vendors," claim CHIME President & CEO Russell P. Branzell and Board Chair Charles E. Christian.


CHIME is also calling on Congress to help simplify quality reporting for healthcare organizations and providers, especially holding off on a requirement to the electronic submission of clinical quality measures (CQMs) until the Centers for Medicare & Medicaid Services (CMS) have conducted sufficient testing of the accuracy and completeness of submitted data.


As for the use case of health data exchange and interoperability, the organization emphasizes the need for Congress to drive standards identification and adoption in nine areas:

1. Patient identifiers

2. Standards for resource locators (e.g. provider directories)

3. Standard terminologies

4. Detailed clinical models

5. Standard clinical data query language based on the models and terminology

6. Standards for security (standard roles and standards for naming types of protected data)

7. Standard Application Program Interfaces (APIs)

8. Standard transport protocols

9. Standards for expressing clinical decision support algorithms

Additionally, CHIME calls into question the ability of the health IT certification program administered by Office of the National Coordinator for Health Information Technology (ONC) to ensure interoperability between certified EHR technology (CEHRT).

The organization maintains that Congress should require the ONC to change its approach to testing, enhance ONC's ability to enforce adherence to the certification program, and enable greater transparency into the interoperability of CEHRT.


The CHIME letter also include recommendations related to patient engagement and IT resources to improve patient safety. For the former, the organization makes the case for CMS to consider alternatives to the patient portal for providers to more effectively engage their patients. "Congress should consider the discrepancy between HHS’ priorities for patient engagement, and patients’ self-indicated priorities," argue Branzell and Christian.


For the latter, CHIME reiterates the dangers presented by limited EHR interoperability and again calls for a patient identification strategy to avoid errors.


Patient privacy is the last of the five use cases covered by CHIME. " CHIME calls on Congress to lead an open dialogue to help states align privacy and consent policies that enable cross border exchange of health information in a secure manner. This should include reexamining certain provisions of the Health Insurance Portability and Accountability Act (HIPAA)," the letter states.


The letter concludes with one additional caveat — changes to meaningful use requirements. These recommendations for the EHR Incentive Programs include a delay for Stage 3 Meaningful Use and a revised approach to measuring quality among others.

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Infographic: An Illustrated History of EHR

Infographic: An Illustrated History of EHR | EHR and Health IT Consulting | Scoop.it

Love them or hate them, Electronic Health Records (EHRs) are here to stay! We built a handy dandy infographic to illustrate the history of EHRs.  We hope you find the information useful and interesting.

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Three EHR 'Add-Ons' to Boost Your Practice's Efficiency

Three EHR 'Add-Ons' to Boost Your Practice's Efficiency | EHR and Health IT Consulting | Scoop.it

Your practice invested in its EHR for a variety of reasons. Sure, achieving meaningful use was a part of the equation. But you also saw the promise of making your practice more efficient. If driving efficiency's still in your game plan, here are three EHR "add-ons" you may want to consider.


1. A scanning solution


One option is adding a scanning system to your EHR, said Joncé Smith, vice president of revenue management at Bethel Park, Penn.-based Stoltenberg Consulting. With a scanning solution connected to your EHR, you can create a digital archive of patients' insurance information, their contact details, and their signed HIPAA consent forms. "A scanning system is helpful to the front-office staff who are trying to schedule a follow-up appointment and to the billing office if they run into a problem with insurance. If the billing staff can't resolve a problem with a patient's insurance, they can contact the patient directly," she said.


2. A practice management system


If you want to streamline billing and scheduling, a practice management system that includes both capabilities may be a good fit. Selecting a practice management system provided by your EHR vendor is key, advised Morris Stemp, CEO of Long Island City, NY-based Stemp Systems, a healthcare IT consulting firm.


"If you're using systems from two different vendors, you're going to be duplicating data. Anytime you have to manually enter information from one system to another, you leave yourself open to human error," he said. While integrations between systems from different vendors can be helpful, those integrations break, noted Stemp. "When an integration breaks and your practice stops functioning, who's responsible for fixing what's broken if there are two vendors involved?"


While Stemp acknowledged that switching in order to have practice management and EHR platforms from the same vendor can be a costly proposition, over time the benefits outweigh the costs. If you have platforms from two different vendors and either vendor updates its software, you'll probably need to update those integrations. Neither the practice management nor the EHR vendor wants to invest in supporting integrations to a variable number of other systems, he said.


3. A data analytics solution


Data analytics tools should also be on the short list, according to Shane Pilcher, vice president at Stoltenberg Consulting. "There's a [data analytics] tool and process for every size organization. [Data analytics] can take your revenue cycle data and pair it with data from the clinical side of your practice, and you can see how your practice is really taking care of your patients. With this information in hand, you can really make decisions and changes to the way you deliver care. You can improve patient outcomes and decrease the cost of care, which impacts your bottom line," he said.


With access to this data — in the form of dashboards and visual roadmaps — practice leadership can have access to information pulled from disparate systems, advised Smith. For example, with a data analytics solution, practices could have greater insight into which patients are using their patient portal successfully and then align resources around making the patient portal more user friendly.

Technology's not going to fix all of your problems, though. Any smart practice should make sure to fix any broken processes before throwing technology at a problem and hoping for a "fix," advised Pilcher.

"Putting new technology around an inefficient process only exacerbates that inefficiency," he said. Pilcher's advice? "Look at the processes that you're using, identify changes and make them more efficient, and then wrap technology around that. That's going to allow you to see a bigger return on investment and better success of the overall project."

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How Small- and Medium-Sized Practices Can Use Big Data

How Small- and Medium-Sized Practices Can Use Big Data | EHR and Health IT Consulting | Scoop.it

Is big data the right fit for your practice? It could be if you're part of an accountable care organization (ACO) or a Patient-Centered Medical Home (PCMH) and your practice is now directly accountable for keeping your patients healthy.


Dan O'Connor, vice president of client relations at Bethel Park, Penn.-based Stoltenberg Consulting, likes to talk about the TV show "House" when describing how big data works in healthcare. On "House," which ran on Fox for eight seasons and finished up in 2012, patients presented with two or three symptoms of a particularly exotic disease and Dr. House spent the entire episode wracking his brain — and the brains of his clinical team — to diagnose and then treat these patients.


When it comes to big data in healthcare, you take that idea about focusing on one patient and you apply it to searching vast amounts of data based on key words to bring back relevant information to your practice. O'Connor said that practices that are trying to embrace the PCMH and ACO models need to be able to utilize all the data they have access to within their EHR and claims data from payers.


When Amarillo Medical Specialists joined an ACO — along with nine other physician practices — in January 2013, it became immediately apparent that the entire ACO needed to figure out whether the services it was providing were actually serving their patients' needs. Each of the practices in the ACO needed to find out how their costs fit into the overall cost of care, according to William Biggs, an endocrinologist and internal medical physician at the Amarillo, Texas-based practice and medical director of the ACO.


For example, before the practices had access to information about the medications and home health and skilled nursing services prescribed by doctors, they didn't know how much any of these services cost — nor did they know the  quality of the care they were providing to patients.


"When we became accountable as an ACO and saw how much we were spending in those categories and how much was being wasted and not used in a constructive way, that was a big eye opener for the doctors," said Biggs. By analyzing data gleaned from the practices' EHRs, its health information exchange, and claims data from insurance companies and Medicare, the practice was able to determine, for example, the appropriateness of patients' emergency room visits and how medically necessary they were.


This meant that the practices involved in the ACO have had to grapple with how accessible they are to patients, according to Biggs. "Are patients able to [be seen] in a timely fashion when they are ill? Or is the front desk just telling them to go to the emergency room? Or are they put on hold and the message tells them to go to the emergency room if this is an emergency — without talking to anybody?"


Fixing a practice's accessibility problem is left up to the individual practice. Biggs said that typically starts with reviewing urgent calls from patients. One solution can be to provide a usable script to the front desk staff that walks them through helping a patient decide if an emergency room visit is required. Having a nurse available to triage patients is also helpful, as is leaving enough slack in the schedule to work in urgent patients rather than sending them to the emergency room.


In its first year, the ACO was able to save Medicare about $4.85 million. About half of that amount was shared among the practices, and a large portion of that amount was shared with the doctors in bonuses. The ACO also saw a 23 percent reduction in hospitalizations in the first 18 months.

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Do Stage 3 Meaningful Use Requirements Need More Flexibility?

Do Stage 3 Meaningful Use Requirements Need More Flexibility? | EHR and Health IT Consulting | Scoop.it

As the Centers for Medicare & Medicaid Services (CMS) continues to tweak the EHR Incentive Programs and its subsequent meaningful use requirements, a variety of healthcare organizations and associations have sent forward their comments to proposed changes. For instance, the American Academy of Family Physicians (AAFP) believes that CMS should delay the implementation deadline of the proposed Stage 3 Meaningful Use requirements.


AAFP Board Chair Reid Blackwelder, M.D., of Kingsport, Tenn., sent a letter addressed to CMS Acting Administrator Andrew Slavitt in which he explained that the timing of Stage 3 Meaningful Use requirements collides with the Medicare Access and CHIP (Children's Health Insurance Program) Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS).


Blackwelder asks CMS to delay the deadline for Stage 3 and wait until there is more efficient integration of certain MIPS requirements and the objectives under the Medicare and Medicaid EHR Incentive Programs. Additionally, Blackwelder feels more time is needed to develop interoperable and effective health IT systems before Stage 3 Meaningful Use requirements should be out in full force.


“Current health IT does not yet have the interoperability required to support value-based payment nor the functionality to be efficient and effective in this new paradigm. We strongly urge CMS to delay Meaningful Use Stage 3,” Blackwelder stated in the letter.


“The AAFP opposes the agency’s proposal to remove the 90-day EHR reporting period currently available to eligible professionals, eligible hospitals, and critical access hospitals attempting to demonstrate meaningful use for the first time and instead require them to report a full calendar year reporting period after 2015. This proposal places an enormous burden on all new adopters of EHRs but also those struggling to modernize their practices and meaningfully use an EHR.”

The AAFP feels that CMS should consider using the currently-in-place 90-day reporting period instead while expecting that healthcare providers will continue using certified EHR technology year-round.

Also, the AAFP representative explained that CMS should institute a policy in which healthcare providers can gradually progress through the meaningful use stages as they see fit instead of mandating that providers move toward Stage 3 Meaningful Use requirements “in 2017 and beyond.”


Additionally, the all-or-nothing approach that CMS has put forward when it comes to meeting meaningful use requirements poses significant difficulties to providers who are attempting to attest to the objectives but may have some barriers to overcome. Allowing for certain leniencies and exceptions that lead to partial financial incentives under the EHR Incentive Programs or at least prevents the payment penalty from occurring could be an important part of meaningful use requirements going forward.


As CMS continues to parse through comments and develop more consistent Stage 3 Meaningful Use requirements over the coming days, the future of the healthcare industry will depend on whether more flexibility will be offered through the final Stage 3 ruling and whether the deadlines for meaningful use regulations will be postponed.

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How health systems can help physician practices prepare for ICD-10

How health systems can help physician practices prepare for ICD-10 | EHR and Health IT Consulting | Scoop.it

Many physician practices are ill-prepared for ICD-10, and health systems must ensure the right tools are in the hands of those who need them most, according to Bill Reid, senior vice president of product management and partners at SCI Solutions.


"Hospitals risk unsuccessful transitions if physician offices in their communities aren't ready," Reid writes for ICD10Monitor.com. Recent studies show that many still are not, despite the Oct. 1 implementation deadline looming.


For instance, a survey unveiled by the eHealth Initiative earlier this month showed that of 271 providers, half said they have conducted test transactions using ICD-10 codes with payers and clearinghouses. Only 34 percent said they have completed internal testing, while 17 percent have completed external testing.


Eighty-eight percent of test claims were accepted during the Centers for Medicare & Medicaid's second round of ICD-10 testing in April.

There are tools that health systems can use to ensure their "healthcare brethren" are moving forward with ICD-10, according to Reid. A cloud-based business management tool can help create a "crosswalk" to convert the ICD-9 code used most often to ICD-10 equivalents. The business management tools help ensure incidents are coded correctly, he says.


"These electronic bridges help ... make it as easy as possible for community physicians to send in accurate orders and referrals, with the correct codes being used from the start of that workflow," Reid says.


One scenario where this works includes if a patient needs to be scheduled for a CT scan. While the patient is at the practice, staff can use the management tool to schedule the order and while doing so select the prognosis which the program will then autopopulate the correct ICD-9 and ICD-10 codes.

The Workgroup for Electronic Data Interchange has warned that unless all industry segments move forward with implementation of ICD-10, "there will be significant disruption on Oct. 1, 2015."

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Specialty Specific EHR

Specialty Specific EHR | EHR and Health IT Consulting | Scoop.it

What scares me is that if we’re not careful, the specialty specific EHR vendor might be a dying breed. This isn’t because the specialty specific EHR vendors aren’t loved by their users more than the alternatives. Instead it’s the shift towards hospital owned medical practices that puts the specialty specific EHR in danger.


While hospital systems would love to support a best of breed approach to EHR software and allow each specialty to choose their own, I’ve never seen it actually happen. When push comes to shove, the hospital system starts rolling out an EHR vendor that “supports” every one of their specialties. It’s hard to blame an executive for making this choice. The logistics of supporting 20+ EHR vendors is onerous to put it lightly. The efficiency of one EHR vendor for a large multi specialty organization is just impossible to ignore. Long term however, I wonder if the downsides will cause major issues.


I should also declare that I don’t think a specialty specific EHR is always the best option. Some specialty specific EHR software aren’t very good either. In fact, I was recently thinking through the list of medical specialties and there were a lot of specialties where I didn’t know of a specialty specific EHR for them.


The one that struck me the most was that I didn’t know of an OB/GYN specific EHR. Is that really the case? I’ve seen hundreds of EHR and I couldn’t think of ever seeing an OB/GYN specific EHR. Maybe I’ve missed it, and if I have then I’d love to learn about one. I imagine the reason there isn’t one is because many of the larger All in One EHR vendors have put a decent focus on OB/GYN functionality. So, maybe no one wanted to compete with what was out there already? That’s speculation. What’s odd to me though is that OB/GYN seems like the perfect case where a specialty specific EHR could really benefit that specialty. They have some really unique needs and workflows. I’d think there would be massive competition around their specific challenges.

What I’ve also found is even the EHR vendors that are happy to sell to any specialty and probably have a few templates for that specialty (Yes, that’s how many EHR vendors “support” every specialty), even the All In One EHR vendors work better for certain specialties. This is often based on which specialties the EHR vendor had success with first. If 80 of your first 100 EHR sales are to cardiologists, then you can bet that your EHR is going to work better for cardiologists than it will for podiatrists.


With this in mind, let’s work as a community to aggregate a list of specialty specific EHR vendors. I’ll be generous and say that if an EHR vendor works with more than 10 EHR specialties, then it’s not a specialty specific EHR (5 is probably a better number). If you’re an EHR vendor and want to admit which specialties you work better for, then I’d love to hear that too.


Can we find a specialty specific EHR for every medical specialty?

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At AMDIS, AMIA’s Fridsma Promotes the Rethinking of MD Documentation for EHR Usability

At AMDIS, AMIA’s Fridsma Promotes the Rethinking of MD Documentation for EHR Usability | EHR and Health IT Consulting | Scoop.it

On June 24, Doug Fridsma, M.D., Ph.D., in a presentation to the AMDIS Physician-Computer Connection Symposium being held at the Ojai Valley Inn and Spa in Ojai, Calif., shared with CMIO attendees some of the latest activity going on with regard to the American Medical Informatics Association (AMIA), the association of which Fridsma became president and CEO last fall, after having served as chief science officer in the Office of the National Coordinator for Health IT.


Fridsma shared with his CMIO colleagues some of the highlights of the recently released “Report of the AMIA EHR 2020 Task Force on the Status and Future Direction of EHRs,” referred to in shorthand as “EHR 2020.”


As part of the opening of that report, published online on May 29 in the Journal of AMIA (JAMIA), notes, “Over the last five years, stimulated by the changing healthcare environment and the HITECH Meaningful Use (MU) EHR Incentive program, EHR adoption has grown remarkably, and there is early evidence of benefits in safety and quality as a result. However, with this broad adoption many clinicians are voicing concerns that EHR use has had unintended clinical consequences, including reduced time for patient-clinician interaction, transferred new and burdensome data entry tasks to front-line clinicians, and lengthened workdays.” Further, the report’s introduction stated that “Interoperability between different EHR systems has languished despite large efforts. These frustrations are contributing to a decreased satisfaction with professional work life. In professional journals, press reports, on wards and in clinics, we have heard of the difficulties that the transition to EHRs has created.”


With regard to the way forward, the authors of the report said in their introduction, “Ultimately, our goal is to create a robust, integrated, inter-operable health system that includes patients, physician practices, public health and population management, and support for clinical and basic sciences research. EHRs are an important part of this ecosystem, along with many other clinical systems, but future ways in which information is transformed into knowledge will likely require all parts of the ecosystem working together. This ecosystem has been referred to as the ‘learning health system.’”


What’s more, the report’s authors noted, “Potentially every patient encounter could present an opportunity for patients and clinicians alike to contribute to our understanding of health care and participate in research and clinical trials. As part of the learning health system, EHRs have long been touted as beneficial to the safety and quality of health care, and studies have shown potential benefits related to information accessibility, decision support, medication safety, test result management, and many other areas. However, implementation of any new technology leads to new risks and unintended consequences; these too have been well documented.”


Speaking of the release of “EHR 2020,” Fridsma told the AMDIS audience on Wednesday that Senator Lamar Alexander, chair of the Senate HELP Committee, “was running around at Vanderbilt, saying, ‘This is something that addresses a lot of the concerns we have.’”

Fridsma noted in his comments that the effort that led to the “EHR 2020” report predated his tenure at AMIA, but reflects the broad focus of the association at this point in time. “We brought together experts to say, what will the EHR look like in the next few years, and what kinds of things could we discuss? And then the Senat HELP Committee testimony that occurred ten days after this was done” created results. “Lamar Alexander took the five principles and said, ‘I’m going to have five hearings on those principles.’” And that, Fridsma said, is what is expected to happen.


Fridsma summarized the learnings shared in the report by noting four main areas of focus. “The first thing we had in the report,” he said, “was that we need to simplify documentation. We went through a series of discussions on why documentation is so complex. We are accelerating to the next stage, but we’re not necessarily getting to the end goal. So we create a whole series of activities” around physician documentation, as a health system, he said, “one set around what is required by regulation, and the other necessary for patient care. Some of this is tied to how our reimbursement works. But the most important development at ONC was the CMS [Centers for Medicare & Medicaid Services] targets for alternative payment models, because that gives physicians and other providers financial incentives to move forward in this area. That will be more of an incentive than Stage 3 of meaningful use, which was really front-loaded.”


The other areas of focus of the report were the need to make regulation more focused; the need to increase transparency around EHR functions; and the need to encourage innovation. As for encouraging innovation, Fridsma told his audience, “That really speaks to a lot of the work going on at ONC right now around FHIR, etc. We’re moving from document-centered ways of viewing information to data-centered ways of viewing information. The EHRs we are using today are not the EHRs that the people we are training today are going to be using. And the way we’ll get there is to encourage APIs and other solutions.”


And he added that, with regard to the report, “We said, if you’re going to focus regulation and increase transparency and encourage attempts to simplify documentation, make sure to keep your patient at the center, as the North Star.” He added that “Our plan is to pick themes like these over the next year, and to focus on those themes” at AMIA, in a strategic way intended to help guide healthcare industry thinking on EHR development and evolution.

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The Internet of Things: a $117B opportunity for Healthcare

The Internet of Things: a $117B opportunity for Healthcare | EHR and Health IT Consulting | Scoop.it

The Internet of Things, also known as IoT, will radically change the appearance of several industries, above all the healthcare. According to a recent post“The use of IoT is expected to grow fastest in healthcare over the next five years, to the tune of $117 billion by 2020”.


As we already noticed ‘New wearables are emerging rapidly This revolution is likely to create a huge impact on mhealth’.


Which are the areas where the use of IoT will reshape medical care?

Wearable technology

The easiest way of patient monitoring. Wearable technology gadgets are very popular at the time. They are able to monitor a vast range of health markers, such as brainwaves, breathing patterns, blood pressure, calories burned, footsteps, heart rhythms, physical position and balance, and temperature, to name just a few.

Wearables can also remind you, or you family, to take medication.

Telemedicine

All you need is a mobile device. The Internet of Things, through the advancements in telemedicine, let healthcare professionals (HCPs) interact with patients virtually. In other words, physicians can ‘visit’ their patients always and everywhere, avoiding the travel time required to meet faraway patients.


According to Wired, “There are a lot of pros to telemedicine. Convenience is one. Access is another. Then there’s the immediacy of it, too.”

Medical device information system

Recording, Merging and analyzing medical data.

Traditionally HCPs have to record a large quantity of data about their patients.


It takes a long time, and what is worse, it could generate errors. Thanks to IoT, patient data is automatically transmitted to electronic health record (EHR) systems. This will increase accuracy and further will allow caregivers to spend more time providing care.

Doctors still have to analyze all that data, but the Internet of Things allows them to merge digital medical data from vastly different medical devices.


Medical device information system will help improving the delivery of patient care.

Intelligent Hygiene Systems

Hospitals are going to be healthier places. The Internet of Things is going also to increase the quality of care hospitals provide. Even if (public or private) hospitals are the place where you should cure you of a disease, it is a fact that each year more than 2 million patients catch infections during hospital stays!


Recent studies as already proved that Hospitals using the system had an average 105.6% increase in hand hygiene solution dispenses and a decrease in healthcare associated infections (HAI) by more than 24%.

 

IoT has already changed healthcare

But that is just the beginning.


Thanks to the Internet of things Doctors and patients already feel closer than ever. On the other hand, IoT represents also a not to be missed opportunity for Pharma industry. An opportunity that in only five years will make Pharma gain over $117 billion.

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Why Practice Fusion Is The Dominant Player In Cloud-Based Electronic Health Records

Why Practice Fusion Is The Dominant Player In Cloud-Based Electronic Health Records | EHR and Health IT Consulting | Scoop.it

San Francisco-based Practice Fusion, the largest U.S. cloud-based electronic health record (EHR) platform for doctors and patients, on June 18th launched a native version of its EHR optimized for iOS and Android based tablets.


This expansion of technology will allow the 112,000 active health care professionals to securely access their EHR and medical records. Practice Fusion is already regarded as an innovator and trailblazer in the industry, since it is the only Meaningful Use certified EHR with complete continuity and functionality across three separate platforms: desktop, iOS and Android. Beyond that, the platform is free—without monthly fees and does not require any special training for adoption into practice.


“This launch further extends our position as the most dominant, fastest innovating EHR,” said Ryan Howard, Practice Fusion, CEO and Founder. “In addition to having the largest patient-provider community in the country, Practice Fusion is the only EHR available where providers have the ability to quickly and securely access their free EHR on a variety of platforms. This independence empowers providers to use whichever device or platform helps them provide the best possible patient care.”


As the fastest growing EHR in the U.S., Practice Fusion now has over 100 million patient records under active management. In 2014 alone, Practice Fusion’s EHR was utilized to record over 56 million patient visits–nearly 6% of all ambulatory visits in the U.S.


As the transition to mobile devices has been rapidly occurring over the past five years or so, Practice Fusion has responded with clear plans to help expand the user experience. And with nearly 43% of physicians currently using a mobile device in their medical practice, Practice Fusion allows providers to choose which platform best fits in to their workflow.


“As numerous studies show that the adoption of mobile devices by health care professionals increases every year,” explains Howard, “having a secure, mobile EHR is becoming increasingly crucial to providers.”


“With over 20,000 requests within the Practice Fusion community alone, the launch of native iOS and Android based applications demonstrates Practice Fusion’s commitment to empower providers with the latest tools to help them provide quality patient care.”

Howard explains that “the flexibility and connectivity options of our free platform has led to Practice Fusion being confirmed in a recent study by AmericanEHR as the de facto EHR for solo and 1-3 provider clinician offices.”


“With optimized navigation for landscape and portrait devices, the new iOS and Android based applications feature all the same capabilities already valued by Practice Fusion users such as e-prescribing to over 70k pharmacies and connecting with over 550 labs/imaging partners.”

Data from the recent AmericanEHR study in partnership with the American College of Physicians (ACP) demonstrated that Practice Fusion is the clear leader for solo and practices with 1-3 medical providers. The study found that for solo providers, Practice Fusion has 40% greater market share than eClinicalWorks, the next largest competitor in this category. And for small offices with 1-3 medical providers, Practice Fusion also garnered 25% more market share than eClinicalWorks, the next largest competitor in this category. The survey concluded that Practice Fusion is the dominant player in the market of 1-3 member clinician practices. And based on data from the American Medical Association (AMA), almost 60 percent of physicians are members of practices made up of 10 physicians or less, with over 53% of physicians self-employed.


According to Healthit.gov, a federal website that provides comprehensive up-to date information regarding EHRs, the average upfront cost of implementation of an EHR is $33,000 per provider, along with an annual maintenance fee of $4,000. For many smaller practices, this may not be feasible—thus making the case for implementing Practice Fusion, a completely free, Meaningful Use certified EHR.


“With this launch” said Howard, “Practice Fusion becomes the only EHR available that has complete continuity and functionality between a variety of platforms enabling providers to securely access their patients’ medical records.”


“Whether a provider is on their computer or tablet, they will have a completely streamlined and consistent user experience.”

Howard also explained that “For providers who are just adopting an EHR or are looking to use a mobile solution, the ability to not have to learn a new layout or system based on device is invaluable for saving provider time, which is increasingly becoming in short supply.”


As healthcare providers have increasingly grown frustrated with using EHRS in their daily practice, functionality and mobile access are key drivers of what seems to stick. While medical scribes have certainly helped to free providers from data entry during daily clinical activities, being able to access records with ease and confidence–and at low or no cost– are important factors which retain providers going forward.

Howard sums it up this way: “By leveraging the agility of our platform, Practice Fusion is able to adopt solutions in response to industry trends and provider needs. With functionality now across three platforms, providers have the option to choose which solution best suits their workflow preferences and needs, allowing them to focus on what’s most important –treating patients and saving lives.”

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AMIA’s Fridsma Promotes the Rethinking of MD Documentation for EHR Usability

AMIA’s Fridsma Promotes the Rethinking of MD Documentation for EHR Usability | EHR and Health IT Consulting | Scoop.it

On June 24, Doug Fridsma, M.D., Ph.D., in a presentation to the AMDIS Physician-Computer Connection Symposium being held at the Ojai Valley Inn and Spa in Ojai, Calif., shared with CMIO attendees some of the latest activity going on with regard to the American Medical Informatics Association (AMIA), the association of which Fridsma became president and CEO last fall, after having served as chief science officer in the Office of the National Coordinator for Health IT.


Fridsma shared with his CMIO colleagues some of the highlights of the recently released “Report of the AMIA EHR 2020 Task Force on the Status and Future Direction of EHRs,” referred to in shorthand as “EHR 2020.”


As part of the opening of that report, published online on May 29 in the Journal of AMIA (JAMIA), notes, “Over the last five years, stimulated by the changing healthcare environment and the HITECH Meaningful Use (MU) EHR Incentive program, EHR adoption has grown remarkably, and there is early evidence of benefits in safety and quality as a result. However, with this broad adoption many clinicians are voicing concerns that EHR use has had unintended clinical consequences, including reduced time for patient-clinician interaction, transferred new and burdensome data entry tasks to front-line clinicians, and lengthened workdays.” Further, the report’s introduction stated that “Interoperability between different EHR systems has languished despite large efforts. These frustrations are contributing to a decreased satisfaction with professional work life. In professional journals, press reports, on wards and in clinics, we have heard of the difficulties that the transition to EHRs has created.”


With regard to the way forward, the authors of the report said in their introduction, “Ultimately, our goal is to create a robust, integrated, inter-operable health system that includes patients, physician practices, public health and population management, and support for clinical and basic sciences research. EHRs are an important part of this ecosystem, along with many other clinical systems, but future ways in which information is transformed into knowledge will likely require all parts of the ecosystem working together. This ecosystem has been referred to as the ‘learning health system.’”


What’s more, the report’s authors noted, “Potentially every patient encounter could present an opportunity for patients and clinicians alike to contribute to our understanding of health care and participate in research and clinical trials. As part of the learning health system, EHRs have long been touted as beneficial to the safety and quality of health care, and studies have shown potential benefits related to information accessibility, decision support, medication safety, test result management, and many other areas. However, implementation of any new technology leads to new risks and unintended consequences; these too have been well documented.”


Speaking of the release of “EHR 2020,” Fridsma told the AMDIS audience on Wednesday that Senator Lamar Alexander, chair of the Senate HELP Committee, “was running around at Vanderbilt, saying, ‘This is something that addresses a lot of the concerns we have.’”

Fridsma noted in his comments that the effort that led to the “EHR 2020” report predated his tenure at AMIA, but reflects the broad focus of the association at this point in time. “We brought together experts to say, what will the EHR look like in the next few years, and what kinds of things could we discuss? And then the Senat HELP Committee testimony that occurred ten days after this was done” created results. “Lamar Alexander took the five principles and said, ‘I’m going to have five hearings on those principles.’” And that, Fridsma said, is what is expected to happen.


Fridsma summarized the learnings shared in the report by noting four main areas of focus. “The first thing we had in the report,” he said, “was that we need to simplify documentation. We went through a series of discussions on why documentation is so complex. We are accelerating to the next stage, but we’re not necessarily getting to the end goal. So we create a whole series of activities” around physician documentation, as a health system, he said, “one set around what is required by regulation, and the other necessary for patient care. Some of this is tied to how our reimbursement works. But the most important development at ONC was the CMS [Centers for Medicare & Medicaid Services] targets for alternative payment models, because that gives physicians and other providers financial incentives to move forward in this area. That will be more of an incentive than Stage 3 of meaningful use, which was really front-loaded.”


The other areas of focus of the report were the need to make regulation more focused; the need to increase transparency around EHR functions; and the need to encourage innovation. As for encouraging innovation, Fridsma told his audience, “That really speaks to a lot of the work going on at ONC right now around FHIR, etc. We’re moving from document-centered ways of viewing information to data-centered ways of viewing information. The EHRs we are using today are not the EHRs that the people we are training today are going to be using. And the way we’ll get there is to encourage APIs and other solutions.”


And he added that, with regard to the report, “We said, if you’re going to focus regulation and increase transparency and encourage attempts to simplify documentation, make sure to keep your patient at the center, as the North Star.” He added that “Our plan is to pick themes like these over the next year, and to focus on those themes” at AMIA, in a strategic way intended to help guide healthcare industry thinking on EHR development and evolution.

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Staff Training Crucial in ICD-10 Conversion Preparations

Staff Training Crucial in ICD-10 Conversion Preparations | EHR and Health IT Consulting | Scoop.it

Healthcare providers who are behind in their ICD-10 conversion preparations may benefit from following the ICD-10 Quick Start Guide provided by the Centers for Medicare & Medicaid Services (CMS).


The five steps that providers will need to take when it comes to their ICD-10 conversion preparations are the following: (1) developing a plan, (2) training the healthcare staff, (3) updating system processes, (4) working with vendors and health insurers, and (5) testing workflow processes and systems.


When it comes to training the clinical staff (including nurses, doctors, and medical assistants) and moving forward with ICD-10 conversion preparations, it’s vital to focus on new clinical concepts and documentation obtained through ICD-10 codes. When training coding and administrative staff including coders, billers, and practice management employees, the focus should be on ICD-10 fundamentals.


CMS provides a variety of resources including webinars, national provider calls and presentations, the Road to 10 website, and email updates. Physician groups, healthcare organizations, hospitals, payers, and vendors also offer a variety of resources for medical providers who are still behind with some common ICD-10 conversion preparations.


The very first step to take is to identify the top 25 most common ICD-9 codes used in one’s medical facility. Common diagnosis codes are also available on the Road to 10 website and other resources.


Teach your healthcare and coding staff how to code the most common cases using the ICD-10 coding set. Using reports via one’s practice management software and billing documents, providers can better identify the most commonly used ICD-9 codes.


Once the top 25 codes are gathered and there is still time before the ICD-10 implementationdeadline, providers are encouraged to expand ICD-10 coding of typical cases past an additional 50 or more codes. This would ensure the majority of a provider’s cases are managed effectively under ICD-10.


Even though the ICD-10 coding set has expanded to more than 68,000 codes, providers will only need to use a small section of the set. Along with training staff, updating system processes is vital for one’s ICD-10 conversion preparations. All hardcopy and electronic forms need to be updated while information gaps should be resolved before the October 1 deadline.


Clinical documentation will need to include laterality, the number of encounters (initial or subsequent), kinds of fractures, and other information about related complications. It is useful to put together a documentation checklist detailing new concepts that should be captured with ICD-10 codes. Once systems are in place, ICD-10 end-to-end testing is crucial to ensure a healthcare facility is prepared for the October 1 deadline.


“With four months remaining to correct issues discovered during testing, the high rate of successful submission of ICD-10 codes is especially encouraging for physician offices since half the claims submitted for end-to-testing were professional claims,” the Coalition for ICD-10 commented on CMS’ latest ICD-10 end-to-end testing results. “These results indicate that significant progress has been made since the January end-to-end testing with the overall rejection rate dropping from 19 to 12 percent and ICD-10 rejections dropping from 3 to 2 percent.”

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Direct Reimbursement Solutions's curator insight, July 1, 10:10 AM

Excellent advice for ICD-10 preparedness.