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Allscripts And Humana Collaborate to Provide Decision Support Software for MDs Along With Financial Assistance and Incentives For Adopting Allscripts EHR System - June 20, 2011
Orlando, Florida -- We knew this was coming in time when insurers and medical record companies would get a little closer together. The insurers are the big benefactors with both electronic records and billing provided to them. As I read here there looks to be incentives from both companies, Allscripts on the EHR and Humana for rewarding physicians for improved clinical performance, says Brian McCarthy, CEO of Sencilo HealthIT and partner of Allscripts Healthcare.
It does not say specifically who the selected physicians are and where but I am sure more may follow later. This is all about aggregating decision making software services through the EHR at the time of service and the partner for aggregating patient information data is Availity Health Information with their CareProfile patient record system, and you can read is that the company is a collaboration from Humana and Blue Cross Blue Shield of Florida. I am not sure why they have the quote and recommendation from Newt Gingrich on there but that is another matter and we know how he likes to raise money. Availity also offers clearing house services so they make money scrubbing claims for providers as well. For more information contact us at: info@sencilo.com or call us (877) 904-4347
Medical Practice - May 18, 2011
Training Seminar
New Haven Venue, New Haven, CT
Website: http://events.smbnetworksllc.com
Industry: Medical Practice
Keywords: Social Media, Facebook, Electronic Health Records
Intended for Practice Administrators Practice Managers and Managing Physicians
Our Medical Practice Technology day is for the Medical Practices that want to know about: Social Media, The New Frontier Practice Fraud Electronic Health Records, Meaningful Use Maximizing Your Incentive Payments
Electronic Health Records: Green or Polluter? - May 18, 2011
This is the year that billions of dollars in government incentive payments are set to begin flowing to the nation's doctors and hospitals to encourage them to adopt computerized patient records. The goal, of course, is to help improve the quality of care and curb costs.
But what about the environmental impact? That was the question asked by researchers at Kaiser Permanente, a giant health-care group, which covers 8.7 million people in nine states and the District of Columbia.
Kaiser used its own system - 454 clinics and 36 hospitals, using electronic health records - as its laboratory. The answer, published Wednesday in the journal Health Affairs, is that the potential environmental benefit is to reduce carbon dioxide emissions as much as 1.7 million tons a year. That's the pollution equivalent of taking more than 300,000 cars off America's roads.
The upside estimate, to be sure, is mostly wishful thinking today. Only about a quarter of the nation's physicians use electronic health records.
And, as so often the case, the payoff from digital records comes not from the new technology itself, but from the changed work practices that the new computer tool makes possible. In fact, the researchers found that if electronic records simply replace paper records - without changing how things are done - the national impact would be to increase carbon dioxide emissions by 653,000 tons. (Or putting more than 100,000 more cars on the road.)
In the Kaiser system, the researchers conclude, electronic health records have been decidedly green. Their use, the article says, has eliminated 1,000 tons of paper, 68 tons of X-ray film, and lowered gasoline consumption by patients by 3 million gallons a year. That more than offsets the 250 tons of plastic waste a year, mostly from tossing out old computers (all of Kaiser's machines are recycled).
The gas reduction comes from doctors using the electronic records and e-mail to answer inquiries from patients about simple problems, like mild side effects from a drug or muscle strains, and thus avoid visits to a clinic. "What stands out is the opportunity to reduce automobile trips," said Kathy Gerwig, Kaiser's environmental stewardship officer.
"The virtual visits work because of the electronic health records," she explained. "The doctor has your complete medical history, your X-rays, medications you take, and everything else he or she needs at their fingertips."
Kaiser also conserves by tightly managing its data centers. Half of the electricity consumed at Kaiser data centers is used to power its electronic records system. Kaiser uses special software to more efficiently juggle computing tasks, buys electricity-thrifty hardware, and designs its centers to use less air conditioning.
"We did this research for our own purposes, but we also hope to help other health groups optimize their electronic health records for the environment," Ms. Gerwig said.
This article originally appeared in The New York Times, May 4, 2011 by Steve Lohr
Pediatricians call for EHRs support - May 18, 2011
Pediatricians call for EHRs to support medical home model
The establishment of family-centered medical homes for children will need to be backed up by timely, secure, and comprehensive electronic health records (EHRs), the American Academy of Pediatric's (AAP) Council on Clinical IT says in a newly released policy statement.
The medical home "must centralize and support the primary care relationship between the patient/family and healthcare provider through well-designed and well-implemented health information management," AAP said in its statement, which appears both online and in the May issue of the journal Pediatrics. For pediatricians, the core of such systems will be a "lifelong EHR."
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However, many challenges and barriers need to be addressed to get more EHRs in pediatrician's offices, AAP said.
First, the electronic systems should be capable of interoperability-of possessing the ability to share data among different practitioners, along with insurers, billing/scheduling systems, and health information exchanges, AAP said. In particular, one central organizing entity should be established to oversee specific technical, legislative and advocacy efforts.
Also, financial incentives should be used to lessen the risks that small practices will take in acquiring and using EHRs-and in maintaining changes and upgrades, AAP said. The technical challenges in implementing electronic information systems in ambulatory settings, it noted, “are daunting for many practices," especially smaller ones.
Privacy laws will need to be balanced with concerns over confidentiality and sharing data with other providers. Also, clarification is needed on ownership of archived personal health information of children who have grown up and its reuse later on for quality care purposes.
This article originally appeared in EHR Experts publication.
AMA's Program Helps Small Physicians - May 18, 2011
The American Medical Association has unveiled a series of six video tutorials providing step-by-step instructions to help physicians choose, purchase, and implement electronic health records, or EHRs.
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Launched last week, the program was developed as part of the AMA's continuing medical education activities. It targets small physician practices that don't have EHR technology, the organization said.
"We created the series as a primer for physicians and practice staff to understand the key stages of health IT adoption and the implications of the current regulatory environment," said Steven Stack, the AMA's board secretary. "Even though the adoption of health IT is growing, there is still a very large constituency--particularly those in small practices--that is not using health IT today, and most of us access the healthcare system through the small practice."
With many smaller physician group practices lacking the IT skills and resources to navigate the plethora of EHR technology available, the aim of the program is to give users the ability to formulate an approach to adoption of health information technology as well as utilize information about health IT adoption practices and procedures that will lead to successful adoption of the technology.
The first video presents an overview of the impact of health IT on the practice of medicine and its likely effect on a practice.
The second video helps participants assess their own practices to determine their need for health IT and to collect the information they need to select an EHR and prepare for implementation.
The third video helps participants decide which type of EHR would best fit their practice and gives them some pointers on how to select a specific vendor.
The fourth video explains how physicians and staff can plan and prepare for their EHR and describes methods they can use to reap the most benefit with the least pain.
The fifth video presents a variety of ways to implement an EHR.
Finally, the sixth video talks about what to expect and plan for once the practice has implemented an EHR.
"A physician or staff person should be prepared to take notes. They can even print the transcript, write on it, and think about how to apply the guidance to their practice," Stack said. "The important thing is to get started. That doesn't mean a practice will be ready to buy an EHR the next day, but they should know at a high level how to prepare for, select, and implement health IT."
Incentive payments of as much as $44,000 (through Medicare) and $63,750 (through Medicaid) per clinician are available from 2011-2016 for Medicare and 2021 for Medicaid. This funding is intended to provide support to achieve the creation of a nationwide system of EHRs used to improve overall U.S. healthcare quality and value.
The organization encourages physicians to register for the program using computers that have Internet Explorer 6.0 (or higher), Mozilla Firefox 1.5 (or higher), or Safari 1.3 (or higher) and Adobe Flash Player 8.0 (or higher).
Participants will be required to complete a self-assessment and will receive a CME certificate once they've completed the program with a 100% score.
This is an American Medical Association article / American Medical Association.
Patient Demand - May 18, 2011
IT Can Ease Healthcare Staff Shortage
Electronic medical records and other technology can improve quality and manage growing patient demand, according to a survey of health professionals by the American Society for Quality.
Electronic medical records (EMRs) and other IT systems will go a long way toward alleviating an expected shortage of qualified healthcare professionals and staff as health insurance reform takes hold, according to a new poll from the American Society for Quality (ASQ).
The survey of 475 professionals involved in healthcare quality revealed that clinical and operational personnel now are on the same page as IT staff in their belief that IT can help improve quality in healthcare. "I was amazed to see how consonant they were," Dr. Joseph Fortuna, chair of ASQ's Healthcare Division Fortuna, told InformationWeek.
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Milwaukee-based ASQ cited a U.S. Department of Health and Human Services forecast that said healthcare-staffing shortages will worsen starting in 2014, as 32 million more people gain health insurance because of the Patient Protection and Affordable Care Act and aging baby boomers become eligible for Medicare. The shortages will likely result in longer wait times in emergency rooms and to see primary care physicians, greater fragmentation of care, and potentially more medical errors, the survey indicated.
But properly implemented IT can help reduce errors, provide better access to health information, and improve care coordination, said Fortuna, who also is CEO of Prism, a not-for-profit organization in Troy, Mich., that assists medical practices with change management. "The idea is, [survey respondents] are tying it to increased efficiency," Fortuna explained. "At its core, it's a technical transformation as much as a clinical and operational transformation."
One quarter of those surveyed said installing and using health IT systems would do more than any other change to improve quality, given the coming shortages, and 29% ranked it second of five choices. Only the creation of fast-track units to treat and release patients with low-acuity ailments such as sore throats and broken wrists ranked higher, with nearly a third saying that would have the greatest impact on quality.
When asked to choose among various information technologies, 41.7% of the survey pool said that EMRs would have the greatest counter-effect to staff shortages. EMRs beat out clinical decision support systems, computerized physician order entry for medications, telemedicine/remote monitoring, automated dose dispensing, and disease registries, though Fortuna said clinical decision support can "dramatically increase efficiency" of healthcare professionals if it's part of workflow redesign.
Fortuna noted that quality can be measured in terms of both clinical and operational quality, and said more efficient operations can help cut some of the $700 billion in a year in healthcare waste that Americans pay for every year. "What we tend to forget is the operational quality," Fortuna said.
Fortuna stressed the importance of workflow improvements so that IT infrastructure can support delivery of the right information on the right patient at the right time rather than just automating inefficient processes. "The important thing is not to put the cart before the horse," Fortuna cautioned.
This article was written by Neil Versel who is covers the healthcare industry.
Healthcare Report - May 18, 2011
What's The Quality Of Your Healthcare Quality Reporting?
As pay-for-performance programs take center stage, you'll need expert data-gathering skills to get fully reimbursed.
No one ever said that data gathering for healthcare quality reporting would be easy. Fact is, it's usually time-consuming and tedious. Almost as much fun as cleaning out your file cabinet.
Vendors can supply a variety of tools and services to ease the pain, but until practices switch to electronic medical records, the work involves lots of paper cuts. Still, it's a necessary part of a medical practice. For instance, in accountable care organizations, which were recently established under healthcare reform, clinicians can share financial rewards from payers, but only if they improve patient care and outcomes and reduce costs. Top-notch quality-of-care reporting will be essential for an ACO to prove it has reached the necessary performance benchmarks needed to get these incentive payments.
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And even if your facility is not part of an ACO, the bar will be raised. You will have to meet a variety of patient quality standards as the Centers for Medicare and Medicaid Services and private insurers transition from traditional pay-per-service to new pay-for-performance reimbursement programs.
Insurers Share The Pain
Health plans need to gather quality related data about patients from doctors and hospitals in the plans' own efforts to report on their performance. About 90% of the country's health plans report on their performance using the National Committee for Quality Assurance's healthcare effectiveness data and information set, or HEDIS, care measurements. HEDIS offers 75 measures, including the care of specific groups of patients such as those who have had heart attacks and patients with chronic conditions like diabetes and asthma. Among other things, the HEDIS measures look at whether those patients are receiving recommended tests, treatments, and other care linked to better outcomes.
Health plans have traditionally used their HEDIS performance measures to self-examine areas they need to improve, such as whether member patients are receiving recommended preventive care services.
The health plans also report their HEDIS information to employers who regularly shop around for the best health plans to offer their workers. Similarly, consumers can access HEDIS data from the National Committee for Quality Assurance through its annual State of Health Care Quality reports to see how plans stack up.
Another challenge facing health plans: Under healthcare reform, they will soon need to meet certain clinical standards to be part of new health insurance exchanges from which the uninsured will be required to purchase health coverage if they're not eligible for public health programs like Medicare or Medicaid, or if their employers don't offer health insurance.
To report their HEDIS performance measures, health plans must first retrieve, collect, and extract records data from the healthcare providers who actually care for these patients. Health plans want to know, for instance, if the doctors in their plans are providing older patients with cancer screenings and pediatric patients with childhood immunizations.
With health plans being judged for their performance in providing their members with coverage for these care services, the health plans will in turn put pressure on their participating doctors and hospitals to deliver recommended care services that have been linked to better patient outcomes. But as already mentioned, collecting and gathering this data for reporting purposes today isn't easy for the health plans or the healthcare providers they work with.
Why? It gets back to the paper cuts: "A majority of healthcare providers still use paper or only have partial EMRs," said Amy Rees Anderson, CEO of MediConnect Global, a company that provides medical record retrieval, digitization, and management services.
MediConnect assists health plans in gathering large volumes of healthcare providers' paper and electronic records to extract data used for HEDIS reporting.
The company retrieves paper and electronic records from healthcare providers, then makes digitized versions of the information available to health plans in a workflow system. Health plans can securely access the information via a portal, and the data can be extracted and entered into HEDIS reporting forms.
These services simplify work that often involves health plan workers making on-site visits to healthcare providers' offices to gather data from paper charts Anderson said. As more healthcare providers transition to e-health records and roll out data warehouses containing patient information, collecting data for reporting should get easier.
But maintaining momentum of healthcare providers meaningfully using e-health records--including for reporting purposes--might get difficult once the HITECH Act's $27 billion incentive program ends in 2015, Anderson said. At that point, some health plans and insurers may be inclined to reward healthcare providers with small financial incentives per claim just to keep the doctors using the EHRs and, in turn, making reporting a bit easier, she said.
In the meantime, some medical practices are already tackling quality initiatives and performance reporting in a serious way with the help of business intelligence software and digitized patient records.
Digitalized Practices Take The Lead
South East Texas Medical Associates, a 29-physician practice in Beaumont, Texas, rolled out IBM Cognos BI tools about two years ago to analyze data from patients' e-health records as well as to glean insights into the care its clinicians provide and the outcomes of individuals with chronic illnesses. The tools also enable the practice to audit and adhere to HEDIS and other quality care measures on a daily basis.
"Get started; no matter how long you plan or analyze, you will always find new ways of improving care," said Dr. James Holly, the practice's CEO.
This article was written by Marianne Lolbasuck McGee who follows EHR and related health issues.
Business Models - May 18, 2011
Reimbursement Models
Healthcare Providers Establish Telehealth Reimbursement Models
Creation of revenue streams for remote services means doctors are running out of excuses for dismissing the technology, say Mayo, University of Miami leaders.
Doctors are running out of excuses for not embracing telemedicine, remote patient monitoring, and other forms of telehealth services, attendees at the Institute for Health Technology Transformation Health IT Summit heard this week.
Many physicians still resist telehealth for a variety of reasons. Video consultations take away the tactile part of a patient exam. Insurance companies don't cover electronic communications with patients. Some doctors still view online services, even with established patients, in the same light as prescribing drugs over the Internet for people they don't have an existing relationship with.
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But healthcare providers tend to view insurance companies, not patients, as their customers, since health plans pay most of the bills, Scott Simmons, telehealth director at the University of Miami School of Medicine, said Wednesday in Fort Lauderdale, Fla. Patients might be willing to pay for extra services such as secure electronic communications and video chats with their doctors if they perceive a convenience factor.
"Parents will pay for it for their kids," concurred Claudia Tessier, co-founder and president of the mHealth Initiative, a Boston-based organization that promotes mobile and wireless technologies in healthcare. It may be worth an extra fee to working parents not to have to leave work to bring a sick child to the doctor.
Tessier said that some forward-thinking physicians are effectively volunteering their time for secure online consultations with patients to gain new patients.
The Mayo Clinic has taken this type of approach with robots in emergency departments at outlying hospitals, allowing specialists on main campuses in Rochester, Minn., Jacksonville, Fla., and Scottsdale, Ariz., to help in the treatment of seriously ill or wounded patients. "That is sort of a loss-leader model" that anticipates revenue for "downstream services" such as critical care and surgeries, said Mayo's director of digital imaging, Dr. James Bolling.
Bolling said Mayo has four business models for telehealth. In addition to the loss-leader approach, the clinic generates revenue via some limited fee-for-service reimbursement; contracts with businesses and schools; and a Web portal for self-insured companies that offer employee health services.
That is similar to how the University of Miami sustains its telehealth services. "In the state of Florida, the reimbursement for telehealth is pretty lousy," Simmons said. Instead of relying on insurance reimbursements, Miami provides telemedicine services through annual contracts with community hospitals and physician practices that pay the university per consult.
The telehealth department collaborates with the department of family medicine to treat children at six schools in Miami-Dade County who would not otherwise have access to primary and urgent care, or even a school nurse. Miami also provides remote consultations for Royal Caribbean cruise ships.
Telehealth also allows primary care physicians to "quarterback and really stay in the loop" with patients who have been referred to specialists, Simmons said. This is the whole idea behind the patient-centered medical home, a concept that stresses care coordination and prevention.
Another way to justify the investment in technology is to calculate the savings in postage from sending appointment reminders by SMS rather than snail mail, Tessier said. The immediacy of texting could help reduce costly no-shows, too.
This article originally appeared in the May 13, 2011 issue of Information Week.
Meaningful Use: The Rules Explained At Last - May 4, 2011
Meaningful Use: The Rules Explained At Last
EDITOR'S NOTE: We're happy to bring you the following primer on the rules on how to demonstrate "meaningful use" of an EHR for the purposes of receiving federal stimulus dollars. This backgrounder is a modified excerpt from Physicians Practice's survey, authored by Bob Redling, and also contains updated information from
Physicians Practice editors.
Bob Keaveney
Editorial Director
Physicians Practice
THE BASICS
The EHR incentive program was created by the Health Information Technology for Economic and Clinical Health Act (HITECH Act), part of the federal stimulus package signed by President Obama in 2009. The legislation provides incentives to each physician (and certain other providers) who meet HITECH's requirements.
There are separate programs for Medicare or the Medicaid participants; you must participate in one of these programs to be eligible for the incentive. If you participate in both, you may choose to participate in either incentive program - but not both. You may switch between incentive programs after you start, but only once.
Medicare offers physicians a bonus of up to $44,000 paid over a five-year period starting in 2011.The payments are tied to 75 percent of the physician's annual allowed Medicare Part B charges that year. If you start in 2011 or 2012, you can capture the maximum $18,000 bonus in your first year of participation by billing at least $24,000 in Medicare allowed charges.
Participation in the bonus program ends in 2015, so waiting until 2013 to begin drops your cumulative take to $39,000, and to $24,000 if you start in 2014. After that, physicians who still aren't using EHRs will begin to see their Medicare payments reduced; the penalties will go as high as 5 percent in 2019.
The Medicaid bonuses are geared to patient volume and there's no penalty for not participating. At least 30 percent or more of your patient volume must be Medicaid beneficiaries (but only 20 percent for pediatricians) measured over any continuous 90-day period in the program's first calendar year. Eligible professionals for Medicaid bonuses include nurse practitioners, certified nurse-midwives, and some physician assistants such as those working in rural health clinics or provider shortage areas.
For both programs, CMS will make bonus payments to each eligible professional in your practice. In other words, a group of three internists could receive $132,000 in total if each successfully participates in the Medicare program.
THE RULES
The legislation sets four objectives for physicians to get the stimulus money. You must:
That first bullet concerning the "meaningful use" of an EHR raises questions about what qualifies as meaningful. In response, CMS recently issued final meaningful use rules: 15 mandatory requirements for providers (and 14 for hospitals), as well as a menu of 10 additional requirements, from which providers must select five. You must attest in writing to using your EHR to those capabilities for at least a 90-day period if you start during 2011 and for a full year if you start in 2012 or later. CMS plans to raise the bar further by adding more criteria in subsequent years of the bonus program.
What are the meaningful use criteria? Here is the full list as compiled by David Blumenthal, MD, director of the Office of the National Coordinator for Health Information Technology (ONC) and Marilyn Tavenner, RN, principal deputy administrator of the CMS, in the New England Journal of Medicine. Note: We've modified the list slightly from the version in the New England Journal, in order to make it more user-friendly. The list as originally compiled can be found here.
CORE REQUIREMENTS
To achieve meaningful use of an EHR, providers must meet the following 15 core requirements under the objectives in Stage 1:
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Providers must also meet at least five criteria of the following "menu" of 10:
1. Implement drug formulary checks
2. Incorporate lab test results as structured data.
3. List all patients who have a particular medical condition, for at least one condition.
4. Identify and provide patient-specific educational materials.
5. Reconcile medications and provide summary records during encounters and transitions of care.
6. Show ability to provide data to public health agencies and immunization registries.
7. Send patients preventive and follow-up care reminders.
8. Provide patients with timely electronic access to their health information.
This article originally appeared in the September 2010 issue of Physicians Practice.
Patient Records Protected? - May 4, 2011
Patient Records Protected?
Backup and Restore - this used to be very difficult - now it's a fairly straightforward process
Implementing an EHR backup system can be one of the smartest things you ever do.
Companies need immediate and constant access to critical information to ensure business continuity when disaster strikes.
Most backup solutions make restoring data a cumbersome and risky process if they even work at all. Manually retrieving off-site tapes, and recovering files from these tapes, can be problematic for several reasons. With Sencilo's Cloud Recovery and Restore software we eliminate these issues. Our automated online backup solution guarantees that it gets done. Off-site transmission and storage provides a necessary safeguard for your data, while under the protection of industrial-strength encryption. And instant access to your data allows quick and easy recovery. In addition, your cost savings are not only realized in the lack of hardware, software, tape and tape handling costs, but also in the amount of time saved using this technology.
Using Sencilo's Cloud Backup Recovery and Restore agent-less software online CDP backup service is simple. Our engineers have taken great strides in making sure our data recovery process is easy to manage and straightforward in design. The ability to restore specific files and data components on the fly, and do it quickly, is our core offering. However, our advanced functionality and enhanced features offer much more, and give us major advantages over our competitors.
Sencilo's Cloud Backup is the solution of choice over 250,000 companies who want to take the hassles out of their traditional backup routines and transition to a highly secure and easy to manage off-site storage solution.
With the threat of business interruption on the rise, there has been a vast increase in regulatory requirements. At the same time, customers are also demanding that service providers take steps to secure their data and maintain system uptime. Business Continuity Planning - once a "nice to have" feature - has become mandatory to preserve customer confidence and provide a competitive edge.
Here at Sencilo HealthIT Solutions we understand business continuity is vital to business success. And in today's interconnected world, virtually every aspect of your company's operation is vulnerable to disruption. Some risks could take your business offline for days, but in a competitive environment, even 60 minutes of downtime could prove fatal. As the number of risks to businesses increases, the worst-case scenario "insurance policy" approach to business continuity has become woefully inadequate.
Our Business Continuity Service helps ensure the continuity of business operations and assists with regulatory compliance, improved systems availability, protection of data, and the integration of IT operational risk management strategies. Our services take you from planning and design through implementation and management, with a strong commitment to understanding your ever-changing business requirements.
For more information email us at info@sencilo.com. We'll be glad to assist you with your every need.
