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EHR Spending 4X over IT Annual Growth - January 16, 2011
Orlando Florida -- A new report from IDC Health Insights predicts that the American Recovery and Reinvestment Act Health Information Technology for Economic and Clinical Health (ARRA-HITECH) Act will have the stimulative effect that Congress had hoped for.
Framingham, Mass.-based IDC predicts that total U.S. EHR/EMR spending will grow from $2 billion in 2009 to $3.8 billion in 2015, a compound annual growth rate of 11.5 percent.
That is twice the growth rate for health IT software in general and four times the annual growth rate for the IT market, notes Judy Hanover, research director for IDC Health Insights.
The report, U.S. Electronic Health and Medical Records 2009-2015 Meaningful Use Spending Forecast and Analysis, notes that in a recent survey, 43.7 percent of respondents indicated they would accelerate or aggressively accelerate their plans for EMR deployment as a result of ARRA. Thanks to company's like Sencilo HealthIT Solutions of Lake Mary Florida for their vendor-neutral approach to promoting EHR vendors to medical practices. A Office does not need to be pressured into a vendors single choice when they can have Sencilo determine which of their many EHRs will work best for that customer.
Breaking down the spending by provider type, the report expects spending on ambulatory systems to grow from $633.5 million in 2009 to $1,406 million in 2015, a compound annual growth rate of 14.2 percent. Inpatient system spending is expected to jump from $1,343 million in 2009, to $2,382.8 million in 2015, for a compound annual growth rate of 10 percent.
The report describes the expected impact of several factors, including the development of cloud-based services, which include software as a service and application hosting. Although they are still in their infancy, we are seeing widespread interest in cloud services, especially on the ambulatory side, Hanover says. It is an attractive option for smaller practices lacking IT infrastructure.
The report also notes that consolidation among both providers and vendors will continue to shape the market dynamics. Larger, more complex provider organizations will require more sophisticated EMR/EHR technology, it states. Evolving care delivery and reimbursement models, such as accountable care organizations and patient-centered medical homes, will require flexible, interoperable and scalable solutions. Mergers and acquisitions, along with new vendors entering the market and established, but less successful, vendors exiting the market, will create buyer uncertainty.
For more information call us at: (877) 904-4347 or e-mail us at EHR@sencilo.com
Why 9 out of 10 Medical Offices Failing to Qualify for MU - January 13, 2011
Jacksonville Florida -- Hennepin County Medical Center in Minneapolis had planned to attest to meaningful use of electronic health records in April 2011. But in testimony given to the HIT Standards Committee on Jan. 11, the hospital notes challenges in being ready to attest that should give any hospital pause.
Creating reports for inpatient meaningful use objectives and quality measures has become an onerous, difficult and time consuming process, testified Joanne Sunquist, CIO. This is in spite of the fact that we are working closely with our certified vendor who has provided certified reports. It is our understanding that only one Epic customer has been able to successfully run all of the Eligible Hospital MU reports. Epic did not immediately respond to a request for comment. While Epic is not doing itself much good by hiding out, and lets it face it 9 out of 10 Hospitals and Providers will not pass this year. If a Doctor believes he can purchase some software, hardware and that is it, well there is going to be a lot of disappointment out there.
Several organizations expecting to seek early attestation when it becomes available in April testified on their experiences getting ready for attestation. Because of its reporting challenges, which Sunquist called the largest challenge to seeking attestation, Hennepin County Medical Center now expects to attest later in the year. Reporting meaningful use measures and objectives is difficult for two primary reasons, Sunquist testified.
While our vendor has attempted to define primary and alternative workflows and structured data elements required to support reporting on each objective and quality measure, organizations may or may not have implemented the system using these exact workflows. Therefore, the reports provided by the vendor will not produce accurate results unless we change our workflow and/or documentation requirements. Testing and validating the reports is an iterative process with changes to workflow and ongoing feedback to providers.
This effort multiplied by the number of reports is quite sizeable. What we are seeing is the smart Office Managers turning to outsourced help, consulting firms like Sencilo HealthIT Solutions has geared up for this service and it now working with Doctors on qualifing for MU. The second reason centers on government specifications for meaningful use quality measures, Sunquist noted.
We have thoroughly reviewed the quality measure specifications provided on the CMS Web site. However, the specifications are so specific, the development and records created for MU quality measures are unique and the same records used for the measure in other programs (such as the PQRI) are not uniformly shared for MU. Our organization might already be reporting on a measure or similar measure for other programs, but we must redo the quality measure record build for MU reporting. In many cases, we will be able to share decision support and documentation tools and use the same workflows for capturing the quality measure data, but the measure results are calculated and reported using unique quality measure records and logic.
In addition to difficulty in producing required reports and changing workflows, Hennepin County Medical Center also had to upgrade its reporting database and change database support practices to meet the new reporting requirements. Sunquist in her testimony commended Epic for a range of initiatives to aid clients in achieving meaningful use.
For more information call or email Sencilo HealthIT at: (877) 904-4347 x1910 or MUconsulting@sencilo.com
First EHR Products Certified For Meaningful Use - January 3, 2011
A wave of three dozen ehealth records products are the first to be certified capable of meeting Meaningful Use Stage 1 criteria. The certifications should help doctor practices and hospitals be more confident about the EHR products they are using or planning to purchase.
Certification of EHR products is required for healthcare providers to qualify for the $20 billion-plus incentive funding that is been allotted under the American Recovery and Reinvestment Acts HITECH Act programs for the meaningful use of health IT.
In the new episode of 107 we do an unofficial survey via facebook to find out what gadgets people wish existed.The largest group of products certified so far 33 were announced by the Certification Commission for Health IT; another three product certifications were granted by Drummond Group.
CCHIT and Drummond Group are two of three organizations that the federal governments Office of National Coordinator for Health IT has authorized, at least so far, as a certification and testing bodies under the HITECH Act. The third certification body named by ONC as an Authorized Testing and Certification Body or ATCB, is InfoGard Laboratories.
In order to qualify for the HITECH incentive payments, clinicians and hospitals need to meaningfully use health IT products that have been certified by an ATCB.
Till recently, CCHIT -- which has been around for several years -- was also the first (and only) organization recognized in the health IT circle as a certification body for e-health record products.
However, under HITECH Act, ONC is designating several ATCBs to test and certify products are compliant to the governments meaningful use requirements.
An InfoGard spokeswoman said the company expects to announce its first Meaningful Use Stage 1 certified products in coming weeks.
The products that received certification by Drummond include one complete EHR and two modules.
Unlike complete EHR packages, modules can focus on certain functionality, meeting one or more meaningful use criteria, but not all. Modules can allow healthcare providers additional flexibility in choosing applications that meet their organizations particular needs beyond meaningful use.
The complete EHR package certified by Drummond is ChartLogic Inc.s ChartLogic EMR version 7 for ambulatory care. The two modules that Drummond certified are:
QRS Incs Paradigm version 8.3 for ambulatory care and ifa united i-tech Inc.s ifa EMR version 6 for ambulatory care settings.
Meanwhile, the first wave of 33 products certified by CCHIT as being capable of meeting the 2011-2012 Meaningful Use stage 1 criteria include 19 complete EHR packages and 14 modules.
Here’s the list so far of complete EHR products certified by CCHIT as meeting the ONC ATCB 2011/2012 meaningful use requirements. The list provided by CCHIT includes the vendor, product and version certified, as well as the product’s target use, whether it’s in a hospital or by eligible providers, such as doctor practices and other clinicians in ambulatory settings.
Complete EHRs
In the new episode of 107 we do an unofficial survey via facebook to find out what gadgets people wish existed.ABEL Medical Software Inc. ABELMed EHR - EMR / PM 11 (Eligible Provider)
Allscripts Allscripts MyWay EHR 9.2 (Eligible Provider) Aprima Medical Software Inc. Aprima 2011 (Eligible Provider)
Athenahealth Inc. AthenaClinicals 10.10 (Eligible Provider)
CureMD Corp. CureMD EHR 10 (Eligible Provider) The DocPatientNetwork.com Doctations 2.0 (Eligible Provider) Epic Systems Corporation EpicCare Inpatient - Core EMR Spring 2008 (Hospital)
Epic Systems Corporation EpicCare Ambulatory - Core EMR Spring 2008 (Eligible Provider) GE Healthcare Centricity Advance 10.1 (Eligible Provider)
GloStream, Inc. GloEMR 6.0 (Eligible Provider)
Intuitive Medical Software UroChartEHR 4.0 (Eligible Provider)
MCS - Medical Communication Systems, Inc. iPatientCare 10.8 (Eligible Provider)
Medical Informatics Engineering WebChart EHR 5.1 (Eligible Provider) Meditab Software Inc. IMS v. 14.0 (Eligible Provider) NeoDeck Software’s NeoMed EHR 3.0 (Eligible Provider)
NextGen Healthcare NextGen Ambulatory EHR 5.6 (Eligible Provider)
Nortec Software Inc. Nortec EHR 7.0 (Eligible Provider) Pulse Systems 2011 Pulse Complete EHR 2011 (Eligible Provider)
SuccessEHS SuccessEHS 6.0 (Eligible Provider)
Here are the modules that CCHIT have certified so far as meeting the ONC-ATCB 2011/2012 meaningful use requirements, including vendor, product name, version and targeted user:
Allscripts Allscripts ED 6.3 Service Release 4 (Hospital)
Allscripts Allscripts PeakPractice 5.5 (Eligible Provider)
EClinicalWorks LLC eClinicalWorks 8.0.48 (Eligible Provider)
Health Care Systems, Inc. HCS eMR 4.0 (Hospital)
NexTech Systems Inc. NexTech Practice 2011 9.7 (Eligible Provider)
nextEMR, LLC nextEMR, LLC 1.5.0.0 (Eligible Provider)
PeriGen PeriBirth 4.3.50 (Hospital)
Prognosis Health Information Systems ChartAccess 4 (Hospital)
Sammy Systems SammyEHR 1.1.248 (Eligible Provider)
T-System Technologies, Ltd. T SystemEV 2.7 (Hospital)
Universal EMR Solutions Physicians Solution 5.0 (Eligible Provider)
Vision Infonet Inc. MDCare EMR 4.2 (Eligible Provider)
WellCentive WellCentive Registry Version 2.0 (Eligible Provider)
Wellsoft Corp. Wellsoft EDIS v11 (Hospital)
The healthcare industry is undergoing a sea change as medical records go digital. In this report, we will advise solo to midsize practices on how to get up and running with a server structure ready for electronic medical records, from scoping hardware and selecting software to deciding the in-house vs. outsourced question, says Brian McCarthy CEO and Founder of Sencilo HealthIT Solutions and well known Healthcare consultant since 2003.
Meaningful Use Registration Now Open for Business - January 3, 2011
Orlando, Florida -- Registration for the Medicare incentive program for meaningful use of electronic health records, as well as Medicaid MU programs in 11 states, started on January 3, 2011.
Hospitals and eligible professionals soon registering and completing a 90-day reporting period under the Medicare program could attest meaningful use in April and receive incentive checks in May. Early Medicaid attestation under a much simpler method for demonstrating meaningful use could result in checks being cut in January or February.
Medicaid programs ready on Jan. 3 are Alaska, Iowa, Kentucky, Louisiana, Oklahoma, Michigan, Mississippi, North Carolina, South Carolina, Tennessee and Texas. Registration will open in February in California, Missouri and North Dakota. Other states on a rolling basis will launch their Medicaid meaningful use incentive programs during the spring and summer. We expect Florida to be available in April 2011.
The Centers for Medicare and Medicaid Services' Web site for the meaningful use programs includes a list of starting dates and deadlines for the first year of the Stage 1 meaningful use program:
* October 1, 2010 - Reporting year begins for eligible hospitals and CAHs.
* January 1, 2011 - Reporting year begins for eligible professionals.
* January 3, 2011 - Registration for the Medicare EHR Incentive Program begins.
* January 3, 2011 - For Medicaid providers, states may launch their programs if they so choose.
* April 2011 - Attestation for the Medicare EHR Incentive Program begins.
* May 2011 - EHR Incentive Payments expected to begin.
* July 3, 2011 - Last day for eligible hospitals to begin their 90-day reporting period to demonstrate meaningful use for the Medicare EHR Incentive Program.
* September 30, 2011 - Last day of the federal fiscal year. Reporting year ends for eligible hospitals and CAHs.
* October 1, 2011 - Last day for eligible professionals to begin their 90-day reporting period for calendar year 2011 for the Medicare EHR Incentive Program.
* November 30, 2011 - Last day for eligible hospitals and critical access hospitals to register and attest to receive an Incentive Payment for Federal fiscal year (FY) 2011.
* December 31, 2011 - Reporting year ends for eligible professionals.
* February 29, 2012 - Last day for eligible professionals to register and attest to receive an Incentive Payment for calendar year (CY) 2011.
More information is available at cms.gov/ehrincentiveprograms, cms.gov/EHRIncentivePrograms/10_PathtoPayment.asp
Stimulus 101 - Understanding the HITECH Act and Meaningful Use - January 3, 2011
Orlando Florida -- On February 17, 2009, President Barack Obama signed into law the American Recovery & Reinvestment Act (ARRA). The health IT component of the Bill is the HITECH Act, which appropriates a net $19.5 billion dollars to encourage healthcare organizations to adopt and effectively utilize Electronic Health Records (EHR) and establish health information exchange networks at a regional level, all while ensuring that the systems deployed protect and safeguard the critical patient data at the core of the system.
The opportunity presented by the Bill is enormous. After literally decades of slow but steady progress towards converting our paper-based record system into an electronic one, we now stand poised for a monumental leap forward. The Congressional Budget Office predicted when reviewing the legislation that 90% of physicians and 70% of hospitals will be using a comprehensive, robust Electronic Health Record over the next few years. As a result, the country will save billions of dollars on the provision of healthcare, and our citizens will receive coordinated, informed care from their entire network of providers. Navigating the language of the Bill and the regulations stemming from it is time consuming and onerous, so the following is a plain language summary of the health IT provisions within the
HITECH and the Meaningful Use Rules.
Details of the Investment
There are two portions of the HITECH Act one that provided $2 billion immediately to the Department of Health & Human Services (HHS) and its sub-agency, the Office of the National Coordinator for Health IT (ONC), and directs creation of standards and policy committees, as well as supportive programs; a second that allocates billions to be paid to healthcare providers who demonstrate use of Electronic Health Records. The net cost to the Federal government is anticipated to be approximately $20 billion after savings are achieved through efficiencies, tax revenue and Medicare fee reductions for non-adopters.
Incentive Payments to Physicians and Hospitals
The government is focused on two primary goals in this legislation: moving physicians who have been slow to adopt Electronic Health Records to a computerized environment, and ensuring that patient data no longer sits in silos within individual provider organizations but instead is actively and securely exchanged between healthcare professionals. Therefore, the vast majority of the funds within the HITECH Act are assigned to payments that will reward physicians and hospitals for effectively using a robust, connected EHR system. There is a program designed for those that see large volumes of Medicaid patients, and another for those that accept Medicare, and in order to qualify for the incentives, both physicians and hospitals have to demonstrate, at a high level, three things:
1. Use of a certified EHR product with ePrescribing capability that meets current HHS
standards.
2. Connectivity to other providers to improve access to the full view of a patients health history
3. Ability to report on their use of the technology to HHS
Additionally, because the government wants to spur quick movement in this area, all of the incentives include payments for up to six years but provide the largest payments early in the program, and those that do not demonstrate Meaningful Use of an EHR under the Medicare component of the program will eventually be penalized through lower payments. The incentive payments begin in 2011 to ensure the providers have time to adopt and learn to use the EHR; penalties begin in 2015.
Specifics of the Opportunity
As stated, there are two incentive programs for physicians: Medicare and Medicaid. Physicians will choose program participation.
Medicaid: Eligible providers (EPs) who see more than 30% of patients paying with Medicaid (20% for pediatricians) are eligible for payments of up to $64,000 over six years. The incentives will be calculated through a formula that multiplies 85% by amounts ranging from $25,000 in the first year to $10,000 in subsequent years. Additionally, those meeting the 30% threshold can begin earning the incentive payments even as they adopt, implement and upgrade their EHR software; they can begin proving Meaningful Use of the EHR in the second year of their program participation.
Medicare: Eligible providers (EPs) who do not have a large Medicaid volume but do accept Medicare can earn up to $44,000 over the five years based on a calculation of submitted allowable charges multiplied by 75%, up to the cap for the year. Additionally, EPs operating in a health provider shortage area will be eligible for an incremental increase of 10%, and those delivering care entirely in a hospital environment, such as anesthesiologists, pathologists and ED physicians, are ineligible.
Amount They Will Receive Each Year Year they first file
2011 2012 2013 2014 2015 2016 TOTAL
2011 $18,000 $12,000 $8,000 $4,000 $2,000 $0 $44,000
2012 $0 $18,000 $12,000 $8,000 $4,000 $2,000 $44,000
2013 $0 $0 $15,000 $12,000 $8,000 $4,000 $39,000
2014 $0 $0 $0 $12,000 $8,000 $4,000 $24,000
2015 or Later $0 $0 $0 $0 $0 $0 $0
Fee reductions: Providers who do not demonstrate meaningful use in 2014 will see, in their 2015 fee schedules from Medicare, a decrease of 1%. An additional decrease will be affected in 2016 and 2017 down to a total of 97% of the regular fee schedule; it can further be reduced to 95% if the Secretary determines that total adoption is below 75% in 2018.
Additional Incentives for Physicians Currently Available
Even before the incentive payments or grants became available to qualifying healthcare organizations through the HITECH Act, there were already programs in place to reward physicians who adopt that technology. By maximizing the ePrescribing incentives currently available through the Medicare Improvements for Patients and Providers Acts of 2008 and PQRI incentives, a qualified provider can earn between $6,000 and $8,000 prior to beginning participation in the Stimulus incentives programs.
$2 Billion to HHS / ONC
According to several Funding Opportunity Announcements that have come out of HHS since the passage of the HITECH legislation, there are millions of dollars flowing to the states as they work to establish health information exchange (HIE) initiatives in regions and towns across the country, as well as help existing HIEs to progress in connecting providers. Additional areas of spend are Health IT Regional Extension Centers, which are focused on increasing HER adoption among the smallest primary care offices; the establishment of clarified and strengthened product standards; the extension of the National Health Information Network; and several programs that look to identify best practices in EHR adoption and successful data exchange across communities. Additionally, outside the HITECH Act but in other areas of the Stimulus bill, Secretary Sebelius has responsibility for building and renovating Federally Qualified Health Centers and increasing their use of health IT, helping Indian Health Services organizations adopt EHRs and tele-health services, and improving the technology used to process disability claims, including determining what role EHRs can play in that modernization effort.
Meaningful Use
The Final Rule regarding Meaningful Use was released in a proposed form at the end of 2009 and finalized on July 13, 2010. It provides detail about what physicians and other Eligible Providers (EP)s – will need to do to quality for the HITECH incentive payments.
EPs will need to prove Meaningful Use of their EHR for at least 90 continuous days in 2011
in order to earn an incentive, and then for the entire year each subsequent year.
Physicians need to prove that they have met 20 of 25 different functional objectives with their use of the EHR product to demonstrate meaningful use. These objectives include computerized physician order entry (CPOE), the use of clinical decision alerts, incorporation of lab results into their EHR as discrete data, ePrescribing and electronic information distribution to patients.
Six clinical quality measures will need to be submitted by an EP: three from a Core set of measures (although three alternate core measures are provided), and three from 38 other measures.
Physicians will be paid on a rolling basis as soon as they have proven to CMS that they have met all the functional objectives of the Meaningful Use requirement and have hit the maximum amount for the year. CMS will then issue a single, annual, consolidated payment for the 2011 amount. Subsequent years will be paid following the end of the calendar year.
All reporting will be done by attestation in 2011, moving to an electronic form in later years. The requirements for Meaningful Use were substantially relaxed in the Final Rule. It is expected that the full 25 functional objectives will have to be met for Stage 2, and that the criteria for success will be raised in most cases.
Standards and Certification
With the assistance of the National Institute for Standards and Technology (NIST), the Department of Health and Human Services (HHS) developed specific testing criteria to certify software as being ARRA Certified.The certification testing will be conducted by ACTBs – Approved Certification Testing Bodies who are approved by HHS and managed by the Office of the National Coordinator (ONC). Once approved, these bodies conduct the certification tests, which are then reviewed by them and ONC. There is no particular deadline for bodies to become approved, and approval is issued on a rolling basis.
A system may be certified as a Complete EHR or an EHR Module. A Complete EHR is a system which fulfills all the requirements for demonstrating Meaningful Use (and the other certification requirements) as a single unit. An EHR Module performs some subset of those functions. Vendors may certify components as EHR Modules and then offer them as a bundle which, if it covers all the requirements, will have the same status as a Complete EHR.
As of this writing, there were three ATCBs announced: Certification Commission for Health
Information Technology (CCHIT), Drummond Group and InfoGard Laboratories.
Privacy Expansion
As part of the HITECH Act, Federal privacy and security laws (HIPAA) were expanded to protect patient health information, including:
Defining which actions constitute a breach (including some inadvertent disclosures)
Imposing restrictions on certain disclosures, sales, and marketing of protected health nformation
Requiring an accounting of disclosures to a patient upon request
Authorizing increased civil monetary penalties for HIPAA violations
Granting authority to state attorneys general to enforce HIPAA
Additionally, a mandatory HIPAA Security Risk assessment was included amongst the 15 core requirements to demonstrate Meaningful Use.
For additional information, please e-mail us at: TheTimeIsNOW@sencilo.com
ALLSCRIPTS MYWAY ELECTRONIC HEALTH RECORD RECEIVES ONC ATCB CERTIFICATION FOR MEANINGFUL USE - December 15, 2010
MIAMI FLORIDA – December 15, 2010 – Allscripts MyWay EHR version 9.0 has received Complete EHR Ambulatory certification -- deeming the Electronic Health Record (EHR) software capable of enabling providers to meet the Stage 1 meaningful use measures required to qualify for funding under the American Recovery and Reinvestment Act (ARRA). Tested and certified under the Drummond Group's Electronic Health Records Office of the National Coordinator Authorized Testing and Certification Body (ONC-ATCB) program, the EHR software is 2011/2012 compliant in accordance with the criteria adopted by the Secretary of Health and Human Services.
“The certification of our MyWay EHR provides physicians in independent practice and small groups an electronic health record that is simple, easy to use and that works the way their practice works, while positioning them to qualify for federal incentives under ARRA, said Glen Tullman, Chief Executive Officer of Allscripts. Allscripts is committed to providing physicians and hospitals with the certified solutions they need to take full advantage of this important federal program, which we believe will ultimately lead to better health outcomes for all Americans.
Drummond Group’s ONC-ATCB 2011/2012 certification program tests and certifies that EHRs meet the meaningful use criteria for either eligible provider or hospital technology. In turn, healthcare providers using the EHR systems of certified vendors are qualified to receive federal stimulus monies upon demonstrating meaningful use of the technology -- a key component of the federal government’s push to improve clinical care delivery through the adoption and effective use of EHRs by U.S. healthcare providers. Allscripts is a little late to the tie 1 EHR providers but now that we are ready, it's all blue sky, says Allscripts partner and CEO of Sencilo HealthIT Solutions, Brian McCarthy.
Allscripts MyWay version 9.0, which met the requirements for a Complete EHR Ambulatory, is available as both a hosted SaaS (Software as a Service) and on-premise solution, and offers robust capabilities for electronic health records as well as practice management and claims management. The solution is designed to help independent and smaller physician practices overcome cost and IT complexity barriers.
Allscripts Enterprise, Professional and PeakPractice EHRs, as well as Allscripts ED Emergency Department Information System, were all previously certified 2011/2012 compliant by Drummond Group or other ONC-ATCBs. Allscripts Sunrise Enterprise acute care EHR is expected to receive ONC-ATCB certification before the end of the year.
The need for EHRs in the U.S. healthcare system has been acknowledged for many years. Drummond Group is proud to work with leading healthcare vendors and help them offer certified technologies to health providers across the country. With more than 10 years of software testing experience carried out in several industries, we are confident in our ability to offer an effective and cost-efficient testing process to the healthcare industry, says Rik Drummond, CEO of Drummond Group. The snowball effect could mean great things for clinical care in our country. We can help IT vendors certify their EHR systems – vendors can then help providers implement the EHR solutions to achieve meaningful use and receive incentive funds – and ultimately providers can leverage the systems to improve clinical care across the nation.
This Complete EHR is 2011/2012 compliant and has been certified by Drummond Group, an ONC-ATCB approved to certify any complete or modular EHR both ambulatory and inpatient, in accordance with the applicable certification criteria adopted by the Secretary of Health and Human Services. This certification does not represent an endorsement by the U.S. Department of Health and Human Services or guarantee the receipt of incentive payments. Allscripts, 12/08/2010, MyWay EHR version 9.0, certification number 12082010-8725-1, Clinical Quality Measures Certified: NQF0002, NQF0013, NQF0024, NQF0028, NQF0031, NQF0038, NQF0041, NQF0043, NQF0421; additional software used: email and spreadsheet software.
About Allscripts
Allscripts (NASDAQ: MDRX) provides innovative solutions that empower all stakeholders across the healthcare continuum to deliver world-class outcomes. The company’s clinical, financial, connectivity and information solutions for hospitals, physicians and post-acute organizations are the essential technologies that enable a connected community of health. To learn more about Allscripts, please visit www.allscripts.com, Twitter, Facebook and YouTube.
About Drummond Group
Drummond Group, Inc., the trusted software test lab, provides effective and efficient electronic health record (EHR) testing to healthcare information technology vendors. As an office of the National Coordinator Authorized Testing and Certification Body (ONC-ATCB), Drummond Group works closely with healthcare software vendors to certify EHRs for use by providers that are looking to qualify for incentive funds under the American Recovery and Reinvestment Act (ARRA). Drummond Group is approved to certify both complete and module EHR for both ambulatory and inpatient. Leveraging more than a decade’s worth of interoperability, conformance testing and certification experience in multiple industries, Drummond Group delivers what’s needed in healthcare: highly reliable and readily affordable software testing services. For more information, go to www.drummondgroup.com.
For more information call us at: (877) 904-4347
Not Ready for EMR? How about getting ready by scanning your paper charts - December 6, 2010
Jacksonville, Florida -- Medical practices that have either converted to an EMR solution or are planning the conversion to electronic must decide on how they will integrate existing paper-based patient charts as part of the overall implementation. These charts contain valuable history that should be available to physicians for electronic reference as part of the transition to a comprehensive EMR solution.
Scanning the existing paper-based charts and linking the imaged data to the EMR system is the best way to have access to the legacy chart data as new patient data is being populated directly into the EMR system.
There are a few options practices have in terms of scanning these paper-based charts: 1) Charts can be scanned directly into the EMR system when an existing patient returns. 2) On-site scanning service company can scan all existing patient charts and import directly into EMR system. 3) Charts can be sent off-site to a scanning company to be processed.
Lets look at these options in detail and list the benefits and drawbacks of each:
1) Charts scanned directly into EMR system when patient returns
Benefits
- Not a huge disruption in current practice flow and charts that are converted over time will identify active patients vs. inactive patients.
- Cost-savings of not scanning charts all at one time.
- Charts never leave the premises
Drawbacks
- Paper charts will still take up valuable space in the Practice.
- Practice will continue to absorb off-site storage and retrieval costs.
- Practice will absorb administrative costs of retrieving paper charts, scanning the charts and re-filing.
- Hybrid solution of electronic and paper-based charts delays the ability for the Practice to realize the full benefit of the purchased EMR system.
2) Send charts off-site for scan and processing
Benefits
- Typically lower-cost due to speed of processing.
Drawbacks
- Shipping costs of charts to off-site facility typically absorbed by the practice.
- Image quality and format not optimal due to the speed of processing.
- Charts are off-site out of the control of the practice and not available for reference.
- Time of conversion can be lengthy.
- Once digital images return, practice might be forced to hire consultants to import into EMR system or keep the images in a non-integrated storage repository.
3) On-site scanning service company scans all patient charts and imports into EMR system.
Benefits
- All charts are scanned in batch methodically by an on-site scanning service allowing all charts to quickly be converted and available for electronic access.
- On-site scanning service companies have the experience to optimize image presentation and file size for quick loading and accurate representation.
- Eliminates off-site storage costs and retrieval fees.
- Scanning services have high-volume equipment and software capable of 60 – 85 page per minute rates, specialized barcode processing for patient tagging, image optimization software to enhance poor quality images, and methods for determining the best image format based on the pages being scanned.
- Scanned charts can be imported directly into the EMR system without using practice administration staff.
- Scanned charts imported into the EMR system can be shredded and valuable space taken up by folders and shelves can be freed up.
- Office staff will not be burdened with scanning, retrieval, and chart re-file.
- Efficiencies of being a completely paper-less office can be realized in a few months rather than over a few years.
- Charts never leave the premises and status of charts in process available to practice on-demand.
Drawbacks
- On-site scanning and preparation equipment and people will take up some additional space temporarily during conversion.
- Slight disruption of business when the charts are being processed.
- Cost of conversion is realized up-front.
Option 1 is a slow process that will burden the existing staff and requires the existing paper-charts to remain for an undetermined length of time. Costs of handling paper and storing the paper will continue for many months.
Option 2 is cost-effective initially but the delay in processing, inability to reference chart data while being processed, and the costs to integrate into the EMR system after processing should be considered.
Option 3 is the quickest and most complete way of making sure you get the benefits of electronically referencing legacy data while realizing the day-forward benefit of the implemented EMR solution.
The decision of how to handle existing patient charts can be a tough one like the decision to transition to EMR in the first place. If deciding to go with Option 2 or 3, make sure you contact references to make sure the scanning company you select is reputable.
Hopefully, this information provides practice decision makers additional insight on how existing patient charts can be digitized and integrated in the implemented EMR system. Sencilo has converted charts for multiple practices throughout the US and is ready to talk with you about your chart scanning needs.
For more infomation call (877) 904-4347 or email us at: scanning@sencilo.com
GloStream Seeks to Make Software Easy for Doctors to Use, Built on What They Already Know Microsoft Office - December 3, 2010
Troy, MI-based gloStream calls itself the Microsoft Office of medical practice software. Yet in addition to emulating the business strategy behind Microsofts dominant desktop applications franchise, gloStream has actually built its software for doctors offices on the Redmond, WA-based software giants (NASDAQ:MSFT) technology.
There are thousands of companies that embed Microsoft technology into their software and many that do this for healthcare applications. Yet I am having trouble finding an electronic medical records provider whose fortunes are as extensively tied to Redmond as gloStreams. A doctor can only buy the firms software from Microsoft resellers and partners, Mike Sappington, the firms CEO, says. And built on Microsoft Office, the companys EMR and practice management software actually have Microsoft Word embedded in them.
GloStream certainly is not the first tech firm to hitch itself to Microsoft. The software behemoth owes much of its success to a network of thousands of companies that build applications on Microsoft technology platforms or provide sales and IT support of Microsoft products. But gloStreams part in this network is worth noting because the firm is providing a way for Microsoft partners to become involved in a major surge in technology adoption among U.S. physicians.
The vast majority of doctors in this country rely on paper-based records to store and manage patient data. The federal stimulus last year included $19 billion to help spur adoption of electronic health records systems among physicians and hospitals. While the stimulus subsidizes doctors purchases of the software, the money itself does not solve some bugaboos that have caused doctors to balk at electronic health records in the past. For one, the software can pose challenges to staff members who need to learn how to use it, and it can interrupt an offices workflow, Sappington says. And doctors themselves are obviously busy people, who didn’t go to medical school because they wanted to spend a lot of time learning how to use new software that is not intuitive.
At gloStream, he says, the firm wanted to build easy-to-use software based on Microsoft Office, with which millions of people are already quite familiar. And the five-year-old company decided early on that it would use the thousands of Microsoft partners around the country to sell and support its technology rather than trying to do these things on its own. The firm also believes its strategy allows it to benefit from the billions of dollars that Microsoft spends on Office-related research and development, Sappington says.
The firm says that it is the only provider of EMRs and practice management software that has built Microsoft Office into its applications. Yet there are other health software providers that have also found Microsoft to be a viable technology partner. Allscripts MyWay, for example, uses the Microsoft .NET platform to enable its customers to gain remote Internet access their patient records.
Still, gloStreams use of Microsoft Word has helped make its software more familiar to doctors and their staff, overcoming the major hassles that plagued earlier electronic records systems. Where they have been successful is that the doctors install it, they turn it on, and they say Oh, this looks familiar, and they go, says Bill Crounse, senior director of worldwide health at Microsoft.
In fact, Microsoft once did a survey in the 2002-2003 time frame and learned that thousands of doctors were using Microsoft Office applications such as Word as an electronic health record of sorts for their practices, Crounse says. While Microsoft does not endorse this specific use of Office, he says, it told the company that the familiarity of the applications was a major factor in doctors decisions to use it for storing patients data.
GloStream has found significant support for its strategy. The firm has raised $15 million from investors such as Farmington Hills, MI-based investment firm Beringea, Sappington, and angel backers. (Beringea is one of the largest venture firms in Michigan.) GloStream has 135 employees both here in the U.S. and in India. The company does not publish any user numbers or performance figures because it is privately held, the CEO says, yet he did say that the business is growing.
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Sappington has been around successful IT companies before. He was previously the chief of operations for Netrex Secure Solutions, which was sold to a firm that was eventually acquired by the Armonk, NY-based technology giant IBM (NYSE:IBM). The founders of gloStream are Yaw Kwakye, the firms chief software architect, and Milind Ghyar, its managing director in India. Ghyar previously formed a firm in India to train people on Microsoft technology, according to gloStreams website.
Will GOP Takeover Change HITECH Act Policy and Your Stimulus? - December 3, 2010
Tampa, Florida Two veteran observers of Capitol Hill don't see major health information technology policy changes coming following the Nov. 2 election and change of power in the U.S. House, but there could be some tweaking.
Most folks in Washington haven't centered on the I.T. piece of health policy as reform got much more publicity and attention, says Dan Rode, vice president of policy and government relations at the American Health Information Management Association. "That said, there will be a situation in the House where all expenditures will be looked at very closely," he cautions.
Does that mean there's a chance that some Republican members might start wondering why tens of billions of dollars are slated for spending on electronic health records meaningful use incentives? "I think they will be at least questioned," Rode says. But he adds that the meaningful use funds will be paid incrementally over several years and health I.T. has had bipartisan support for many years.
The change in House leadership, however, could compel some providers who are not eligible for meaningful use incentives, such as long-term care providers, to take a shot at getting in, Rode says. The bottom line on meaningful use, he believes, is that the program will be safe but the administration will have to justify its use of the funds. Certainly, no new money will come into the program. "So, will there be enough momentum in Stage 1 to send a signal to Congress that this is a successful program?" he asks. There's not much time for an answer, as Congress will be working on the 2012 budget starting in March. Keep in mind it was a GOP Whitehouse and Congress that voted on HITECH and passed it in 2004.
Despite the GOP congressional gains, there is not a lot of support for tweaking the HITECH Act, says Brian McCarthy, CEO at EHR vendor Sencilo HealthIT Solutions. He sees no worry that meaningful use will go away, as there is support on both sides of the aisle for the program's goals.
Information technology provisions in Accountable Care Act to reform health care could be more affected by the GOP takeover of the House. Republicans are paying far more attention to reform than HITECH, Barnes notes. But for all the bluster during the election season, Republicans will have limited ability to change the reform law because they don't control the Senate and President Obama still has a veto pen.
Whether mandates to adopt operating rules to tighten the HIPAA transactions and build state health insurance exchanges remain will depend on feedback from middle and small businesses, Rode expects. There may be some House members calling for a pullback on insurance exchanges, but it's not clear what reaction they'd get from consumers.
But the reform debate will far more center on overall issues of health care delivery and payment, ccountable care organizations, liability reform and FDA regulation, McCarthy believes.
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The Transition to Electronic Health Records (EHR) from a Doctors Point of View - December 3, 2010
Miami, Florida -- I have always considered myself to be a little ahead of the curve in life. I have studied hard, applied myself and always gone the extra mile to ensure my success. I worked very hard to establish myself as an internal medicine practitioner and grow my practice on the cutting edge of technology ensuring my respected place among the medical field.
My field has been plagued with increasing demands for burden of proof documentation, changes in coding, payer source modifications and amendments, and to top it all off shrinking reimbursements. Fortunately, I am more the type that embraces change than the type that resists it. I decided to take advantage of the stimulus dollars put forth by the federal government and take the plunge to transition to electronic health records sooner rather than later.
The process began with first trying to decide exactly what I needed in a software program for electronic health records. I had to look at every aspect of my practice, from scheduling to insurance verification to clinical practice to billing and claims management. Then I started my research on the various companies that sold the software for electronic health records. Some contained clinical documentation but no practice management, some contained practice management but no scheduling. I felt like I was trying to compare the proverbial apples to oranges. Night after night, I read and read until I felt semi-comfortable with my new language of information technology and had developed a list of requirements for me to make the transition from paper to an electronic format.
After a significant investment of my personal time, I was feeling pretty good about my list of must haves so I invited a few companies to provide me with a demonstration of their products. I sat through presentation after presentation. I reviewed literature and checklists, read testimony after testimony, and answered question after question about a subject that I thought I had become fairly well-versed in, but come to find out felt completely incompetent in. Electronic health records are so much more than taking my clinical patient charts and turning them into an electronic format. I had to answer questions about hosting versus servers, T1 lines and data migration, back-up and storage and conversion and compliant electronic languages and interfaces and, and, add.
Before I knew it, I was completely overwhelmed and feeling pressured to make a decision. While I recognized that ultimately this would be a good thing for not only my practice but all of the healthcare community, I was almost paralyzed in my decision making. I had to step back and give myself some time to think. I then began research on how to make a decision about which electronic health record software to go with. After several more weeks, I was ready to review my top few choices again and make a decision. Then, came contract negations about whether to: lease or buy; interface with one lab or two; include electronic claims submission, insurance verification, pharmacy prescriptions, faxing and so on. Once these decisions were made, I had to get my credit approved.
Several months later, the implementation process began. Given that I had selected a very big company from whom to buy my products, I was feeling confident that the rest of the process should be smooth sailing. I had rationalized that a company with such a large percentage of market shares, must be doing something right. They had assured me that my local representative would handle all the little details and would soon become my best friend in the information technology (IT) world. I was provided with email contact information and a project number. I reached out through email, anxious to meet my new friend and I waited. I sent another email and again, I waited. Finally, a week and a half later, I received an introductory email from my local representative. I was briefly informed of the upcoming course of action and asked to complete a hardware requirement form. After consulting the cousin of my front desk person, I completed the form and sent it back. It was at this point that I learned that my existing computer hardware was not able to meet the specifications required to run this advanced software. I had to purchase new hardware for my new software to run on. I was furious. After all my research and bargaining to get the best price for this big purchase, I now had to spend an extra $20,000 that I had not planned on! To make matters worse, waiting for the new hardware to be installed caused the implementation and training schedule to be postponed by 3 months. It quickly seemed that dealing with a big company had several disadvantages. They provided me with a project number because I was just that a number.
Finally, the time came for implementation and training to take place. I was expecting my new IT friend to be there with me to walk me and my staff through this process. Instead we were introduced to an interactive webinar for our hands-on learning to take place. While the younger members of my staff were able to adapt, those who were not as tech-savvy struggled with this format. Several weeks later, our local representative came for our go live date. I use the term go live loosely because we could only go live with a few aspects of our electronic health record software. The interfaces and claims processing channels took longer to establish and we were instructed that a member from the technical support department would log in to our computers from corporate headquarters to set this up when the time came. Following our go live day, if we had any questions or issues we were invited to log a case through email and wait for someone to contact us with further instructions.
Despite the arduous journey recounted above, we did survive the transition to electronic health records. If I had it to do all over again, I would have obtained the counsel of a local company who specializes in the various aspects of information technology. Instead of having a local representative of a big company whose interest is pushing their product, I would have chosen someone who had experience dealing with several different brands that would have my best interests at heart. I would have elected to have the training of myself and my staff through incremental sessions at a pace that allows us to create a foundation and then build upon it as our knowledge base expanded. I would have sought the expertise from someone within the IT field who could guide me on hardware, software, and everything in between including a focused needs assessment and corresponding research.
Now that everything is in place, I routinely benefit from the sharing of clinical information among the electronic healthcare field, electronic prescriptions and lab interfaces, online medical research for differential diagnosis and clinical decision making. My office has experienced improved efficiency enabling us to provide our patients with a better overall experience, more personalized customer service and improved clinical outcomes. I am truly pleased that I made the decision to transition to electronic health records sooner rather than later so I could maximize my share of the stimulus funds. I feel proud that my practice is able to offer our patients cutting edge technology. Finally, if given the choice, I would never go back to paper again.
For more information on how Sencilo HealthIT Solutions can transition you from paper records to digital ones call us at: (877) 904-4347 or email us at: transition@sencilo.com or visiti us at: http:www.sencilo.com and let us assist your office.
