Paving the Way for providers to adopt and achieve Meaningful Use of Electronic Health Records

In the latest news update from Health Information technology newsletter from The Office of the National Coordinator for Health Information Technology, Dr. David Blumenthal has letter on the 2010 ONC Update.

In his latest letter, Dr. Blumenthal, National  Coordinator for Health Information Technology, gives an overview of the important policies and programs established this year that are paving the way for providers to adopt and achieve meaningful use of electronic health records.

Dr. Blumenthal also provides information about the 2010 ONC Update meeting on December 14and 15, which will give participants a better understanding of the role of Health IT in health system change and health care reform.

Read Dr. Blumenthal's new letter: 2010 ONC Update to learn more.

Is your Medical Practice Trying To Do Too Much?

In a downturn in the economy, many practices are trying to cope with decreased reimbursements, dwindling patient visits and increased pressure to keep employees happy. They are either adding products or services, or trying medical marketing to target a new patient base.


So, if your practice is experiencing problems, it might be a good time to ask if you are losing focus or you are simply trying to do too much with limited resources? 


For many medical practices, 'marketing' is a bad word. They've never had the need to do marketing. The medical profession is about service to the community, it is said. But you can't serve if you can't eat. Times have changed. 


When your total revenue and revenue per patient has dropped and continues to drop without any good news in sight, what are you to do? Some medical practices have been stripped to bare bones, offering bare bones services. You work harder, longer hours, employee productivity goes down. You even postpone those much needed renovations, replacing a dirty carpet, dirty walls that can use a fresh coat of paint, watching every penny.


Some practices engage consultants to show them how to bring in more revenue, how to manage their practice more efficiently, how to manage collections and receivables. Some practices have resorted to medical marketing, healthcare advertising. The problem is, if not done properly, more dwindling resources go down the wrong path.


Lost productivity and wasted energy can lead to poor moral around the medical practice, which can scare patients off. 


Use technology that is inexpensive and already available to you such as EMR. Here are some strategies that can help:

1. Managing better patient care. Using ePrescription instead of paper.
2. Reducing appointment no-shows by optimizing appointment reminders
3. Streamlining Accounts receivables, even considering outsourcing your billing has been known to help.
4. Using Social media and social networks in the new age of internet, to promote your practice.
5. Creating a patient friendly website that can showcase providers, staff and facilities.
6. Producing Videos that put a real face to a brick-n-mortar practice

If your medical practice is trying to do too much, scale it back and see if you cannot identify areas that need improving. Involve all your employees. Sometimes they come up with the best suggestions. You can build your medical practice's name recognition. Over time, more people will seek out your medical practice; it especially helps if you offer something no competitor does, demonstrating technology savvy leadership such as using Electronic Medical Records, Internet and Social Media. Look at all your options, a balanced approach is often needed when running a business.

7 Tips for Recognizing your Employees

Everyone talks about the value of Employees. It becomes fashionable to talk about 'employeeship' and 'employee recognition'. Empowerment became a big word in the Management Consulting arena. Managers love to say they believe in empowerment.

While employee recognition is much talked about, it is often sadly overlooked. Recognizing and rewarding employees is not easy. It can backfire very easily. It seems managers either get it, or they just don't.

Recognition has to be sincere and genuine. If it isn't your employees will know it- wouldn't you?

Here are 7 tips for recognizing your employees. These are great ideas that educate, motivate and inspire your team. Even better, these tips are not going to cost you a dime. A happy, invested team will always outperform bitter employees that are just doing a job.

7 Tips for Recognizing your Employees

1. Proactively Inform. Employees feel empowered when they are better informed. Not just when they ask or demand it, but when it is volunteered. Many Practice managers and owners make the mistake of keeping all the information to themselves. Instead, share them with your team. Don't just share the bad or negative information as in, 'our reimbursements are really going down so we need to cut costs', but also when times are good and revenue is up. By giving your employees information, you empower them to make informed, confident decisions and choices which not only benefit them but your entire Practice.
2. Mr. and Miss Independent. No one likes being micromanaged - do you? Employees value independence, so give it to them! When you work with your front desk person, or MA, or Nurse, or biller, tell them what needs to be done and then give them the ability to decide how to do it. You will increase their independence and ability to take more ownership of their role. If you have employee(s) that cannot think independently, you need to question if you've hired the right person.
3. Be Flexible. Everyone appreciates flexibility in their work. I know flex hours or working from home is not an option in a medical practice setting. However, there are ways to afford flexibility in terms of accommodating personal lives. Find ways to be flexible and employees will always respond positively.
4. Give more, Get more. Training and development is an ongoing process. It is not a one-time event. Provide employees opportunities to grow and learn by investing in their development. If they want to learn a skill, facilitate it, even pay for it. It shows your employees that you trust, respect and want the best for them. You will be rewarded when they perform at higher levels with each opportunity. This is one of those things you must genuinely believe in.
5. Decisions. Not even a 10 year old likes decisions being made for them all the time. So don't make the mistake of making all decisions for your employees all the time. They are closer than anyone to the work, to the patients; they are really the best decision makers. Of course, I'm not saying leave the practice to them. Take a step back and ask them what they think and what they recommend. They'll be more involved in the process and therefore more invested in the outcome.
6. How am I doing? Everyone wants to know how they are doing at any time, so hold frequent check-ins throughout the year so that you can have honest conversations about their performance. It will give you an opportunity to implement some things we are covering here.  You don't need a formal 'Review Process' as held by larger corporations. The more feedback you give your employees, the more they will be equipped to respond to the needs of your Practice.
7. Celebrate! Often we are so busy with the Practice, working, strategizing, executing ideas that we cruise through the year without taking time to celebrate all the successes along the way.We do have successes and it is paramount to celebrate them. Celebrate small successes, celebrate often and you'll get more back in return. Don't wait for the big event. You will foster a culture of recognition. 

House Approves Temporary Medicare Fee Schedule Fix; 2011 Rates Include 30% Cut

Here we go again! Reimbursement rates for 2011, scheduled to take effect January 1, include a 30% cut. 

On November 30, 2010, the U.S. House of Representatives approved the Senate-passed bill that stops a projected 23% cut in the Medicare Physician Fee Schedule and extends the current payment rates through December 31. The legislation pays for the extension by implementing a policy that reduces the payment rate for second and subsequent speech-language, occupational therapy, or physical therapy treatments provided to the same patient on the same day.

However, most Medicare observers expect Congress to enact legislation to prevent implementation of these dramatic cuts.

In spite of Electronic Medical Records incentives, whether client server based EMR or EHR where there is a substantial investment or Web-based EHR or web-based EMR, where upfront investments are less or next to nothing, physicians are still reluctant to adopt electronic medical record systems and are adopting a wait and watch policy when it comes to any incentives from CMS.

EHR Future is NOW!

Here is what QSII - Nextgen said in its 'Analyst Day' recently;


"Management plans to keep moving software functionality into the cloud. QSII hopes to be
able to offer its clients a fully web-based alternative within the next year."

So, is this the future?

To me, Nextgen is just in a catch-up mode. They're lagging behind industry leaders like Waiting Room Solutions with respect to web-based, SaaS, Cloud based, or whatever fancy name you want to give it.

So why is EHR in Cloud computing the future?

1. Reduced cost - Cloud computing is paid incrementally. The benefit accrues to providers. Typical cost of implementing EHR in a clinic based client-server environment can range from $30,000-$50,000 per provider.
2. Safe-Increased storage - Clinics can store more data safely. Now with EHR and interoperability becoming a way of life, more and more data will be stored. Just as with paper charts, data keeps on growing. It is true that cost of hard drives continues to go down but cost of secure quality data storage is not cheap; not to mention secure backup.
3. Highly Automated - No one needs to worry about keeping computers and software up to date. This can be a big relief for small to mid size practices as they tend not to have IT personnel on staff. 
4. More Mobility - This is a huge benefit to providers when they have to go across multiple locations or even have the ability to work from home or hospital.
5. Flexibility - Allows providers to be extremely flexible compared to past computing methods - hardware and software.

If you're concerned about security, all I can say is, wake up, times have changed. Majority of the top Fortune 50 companies have their most vital data - "Sales" data - on a cloud, entrusted with one company - salesforce.com

That should tell you something. Technology and process have matured and gotten extremely strong. Read my blog about healthcare data theft. There's perhaps a better chance of losing data from your laptop than cloud.

Laptop thefts top cause of health data breaches

Physicians using Waiting Room Solutions EHR can rest peacefully knowing that even if their computer (desktop or laptop) is stolen, their office broken into, their patient data is safe.


Read on...


Laptop theft is the most prevalent cause of the breach of health information affecting more than 500 people, according to the Health & Human Services Department, which last year began tracking data breaches by public and private healthcare organizations.

The fact that laptops are so easily stolen underscores the importance of physical security in the protection of health information, according to Adam Greene, senior health IT and privacy specialist in HHS’ Office for Civil Rights, which enforces the privacy and security rules under the Health Insurance Portability and Accountability Act (HIPAA).

Of the 189 records of data breaches affecting more than 500 individuals in the first year, 52 percent were from theft. About 20 percent were from unauthorized access and disclosure of protected information, while 16 percent were from loss, he said Nov. 10 at the mHealth Summit conference.

Laptops were involved in 24 percent of data breaches affecting more than 500 people and paper records were close behind at 22 percent. Desktop computers accounted for 16 percent of the breaches and portable devices such as smart phones accounted for 14 percent.

Waiting Room Solutions EHR keeps data at a secure location that is accessed by healthcare professionals using a simple browser. There is no local data storage. All transactions happen via a very highly secure transmission.

Time period for Medicare Allowable charges

Time period for Medicare Allowable charges


This is a great post related to Medicare allowable charges.


http://www.emrandhipaa.com/emr-and-hipaa/2010/11/09/emr-stimulus-question-and-answer-time-period-for-medicare-allowable-charges/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:+EmrAndHipaa+(EMR+and+HIPAA)&utm_content=My+Yahoo


Let me summarize this...


Question: To qualify for EMR stimulus money we need $24,000 in allowable medicare charges per physician. I am not sure whether we have to show the $24,000 over a period of 1 year or 90 days. Can you please clarify?


Answer: The short answer is you have the entire year to accrue the $24,000 in allowable Medicare charges that’s required to get the full EMR stimulus money in year 1 (you get paid 75% of your Medicare allowable charges up to the cap for that year)


Two more questions emerge from this conversation.
1. How do you show meaningful use for 90 days of stage 1 of the year? Is there an automatic report generated from a qualified/certified EMR system? Do you have control over the reporting period?
Answer: Report is generated from the EMR system. EPs have to physically generate the report for a specific reporting period of minimum 90 consecutive days. After the first year however, it does not matter because you have to show meaningful use for the entire year - 365 days.


2. Do you have to show meaningful use for 90 consecutive calendar days?
Answer: Yes. It seems the words 'consecutive days' means calendar days, not working days. So, what if you are on vacation for 30 days within those 90 days? i.e. you start reporting October 1, go on vacation from Nov 15 - Dec 15, return and continue working Dec 16 - Dec 31? 


3. What if you show proper meaningful use in the first two years and and unable to meet the criteria of 365 days reporting in year 3? Do you have to return the money you got for the first two years? What if you restart proper usage in Year 4? Would you be qualified to receive money in year 4? How much?

Tax incentives for buying EMR and EHR Software

Dear Doctor,

I know you’ve been bombarded with details of Stimulus Incentives from various corners. You’ve probably decided that sooner or later, you’ve going to go electronic and get EHR technology.

But, here’s another great reason to buy in calendar year 2010. Combined with Stimulus, it makes a compelling case to get EHR now!

· September 27, 2010, President Obama signed into law a bill (H.R. 5297), that includes a retroactive extension of the 50% bonus depreciation provision that expired last December.

· This will allow customers to write off an additional 50% of the cost of qualifying assets (including software) acquired and placed in service in 2010.

Importantly, this legislation sunsets 12/31/2010, and presents a compelling reason to buy in calendar 2010 (to spend year end budget, pull forward future spend, or a reason to place orders in December rather than January).

I learned long time ago that people fail not programs, the programs mentioned above will work for the good of all if followed as outlined. I think the program is a GOD send for those who have vision. I see great visions here and to put it short and brief this lemon is ready to be turned into lemonade.

By allowing a 100% deduction of capital investments, businesses of all sizes will be allowed to keep more money now and would give you an incentive to spend and invest.

Fine print - I'm not a tax consultant and this is not tax advise.

Confused with EMR selection?

You are not alone. I don't think we can trust the reliability of web published EMR/EHR ratings. I agree with John 100% (http://www.emrandehr.com/2010/10/20/emr-and-ehr-rating-websites/)

I am not sure I want to trust any of the surveys and polls that so called professional organizations conduct. Plenty of surveys and polls that are conducted by 'independent' agencies get their funding from 'sponsors' that skew results in their favor.

RECs (Regional Extension Centers) is another behemoth in creation. The RECs that I've seen are all the same people all over again.

I cannot agree with one reader more, 'I can’t recall ever researching something so thoroughly and have so much information available to me and yet be still so utterly confused.'

Ideal EMR/EHR

Trying to define an ideal EMR/EHR is like trying to define an ideal car. There ain't no such thing.

How do you go about buying a car?

If you are one of the few that don't have a favorite car to buy, you probably start with style - sedan, SUV, minivan. You look at crash ratings for safety, you look at price, maybe some more criteria. You narrow down to a few manufacturers and models. If you're in the market for family sedans, you probably have a short list: Ford Fusion, Honda Accord, Toyota Camry, Chevy Malibu, and a few more.

What do you do then? Do a little price check. Pretty soon you find they're in the same 'price range'.

Next, TEST DRIVE!

You may like one, your spouse may like another one. This is exactly how EMR/EHR buying works. You have to test drive.

Of course, you will must your colleagues, seek references, check reviews, blogs and so on, but you must 'test drive'. By this, what I mean is, see a demo. I suggest see two demos. After the first round of 'sales demos', pick the one you like best and ask for a detailed demo where you can ask pointed questions related to your practice, and try to see how this software will work in your environment.

If you now feel comfortable, that EMR/EHR is the one you go with.

Believe me, it is not as complicated as some people make it out to be.