_______________________________________________________________________________ Overview of the ARRA sometimes referred to as the HITECH Healthcare Stimulus Act
What does the ARRA aka “Stimulus Bill” mean to the Physician? What is at stake?
There is a great opportunity for any non-hospital employed physician under this new legislation to take advantage of financial incentives that come with an Electronic Health Records (EHR) purchase, while simultaneously putting in place the infrastructure that will allow them to enhance their patient care capabilities with all that electronic health automation offers.
What is the extent of the financing available through this HITECH legislation?
• The Bill currently provides approximately $17 billion in funds slated for Physician Incentives
•
Eligible physicians can receive up to $44,000 over a five-year period
•
Each individual non-hospital employed physician is eligible to receive this incentive
regardless of the size of the practice or group
•
Incentives/ Healthcare funding will start in October 1st, 2011
Medicare Incentive Schedule Per Year:
Who is Eligible?
• Available to all non-hospital employed physicians who see Medicare patients
- Minimum for Medicare participation
- Each eligible Physician must bill Medicare 125% of the total incentive received over the
five-year period of incentive distribution or $55,000 over a 5 year period of time to qualify
- Must prove “Meaningful Use” of a “Certified” Electronic Health Record (EHR)
What is the definition of a “Certified” Electronic Health Record (EHR)?
• Per wording within the HITECH legislation, in order for a physician to qualify for Medicare
Incentives the physician must be using a “Certified EHR”
Product Certification Standards by 12/31/09 that will definitively define “Certification”
• The Bill also allows HHS to endorse a current, private voluntary body as the standards
organization
It is the general consensus that CCHIT (Certification Commission on Health Information Technology) will be that group and it is widely believed that the “Certification Standards” outlined by this organization will at a minimum be the starting point.
To date, software manufactures have had to apply for CCHIT certification on an annual basis
2008 Certification is already completed and applications have been closed
2009/2010 criteria is currently being developed by the Office of the National Coordinator (ONC) and is due for submission to the US Department of Health and Human Services (HHS) by August 26th, 2009. It is also widely believed that the annual certification standards published by the HHS will continue to evolve over time and become more stringent year after year.
CMS and the Office of National Coordination for Health Information Technology (ONC) announced Wednesday, December 30, 2009 at 4:15 PM EST the following 25 criteria which needs to be met in order for eligible providers to demonstrate “meaningful use” of a certified EHR.
[1] Objective: Use CPOE
Measure: CPOE is used for at least 80 percent of all orders
[2] Objective: Implement drug-drug, drug-allergy, drug- formulary checks
Measure: The EP has enabled this functionality
[3] Objective: Maintain an up-to-date problem list of current and active diagnoses based on ICD-9-CM or SNOMED CT®
Measure: At least 80 percent of all unique patients seen by the EP have at least one entry or an indication of none recorded as structured data.
[4] Objective: Generate and transmit permissible prescriptions electronically (eRx).
Measure: At least 75 percent of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology.
[5] Objective: Maintain active medication list.
[6] Objective: Maintain active medication allergy list.
[7] Objective: Record demographics.
[8] Objective: Record and chart changes in vital signs.
[9] Objective: Record smoking status for patients 13 years old or older
[10] Objective: Incorporate clinical lab-test results into EHR as structured data.
[11] Objective: Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, and outreach.
[12] Objective: Report ambulatory quality measures to CMS or the States.
[13] Objective: Send reminders to patients per patient preference for preventive/ follow-up care
[14] Objective: Implement five clinical decision support rules relevant to specialty or high clinical priority, including for diagnostic test ordering, along with the ability to track compliance with those rules
[15] Objective: Check insurance eligibility electronically from public and private payers
16] Objective: Submit claims electronically to public and private payers.
[17] Objective: Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, and allergies) upon request
[18] Objective: Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, allergies)
[19] Objective: Provide clinical summaries to patients for each office visit.
[20] Objective: Capability to exchange key clinical information (for example, problem list, medication list, allergies, and diagnostic test results), among providers of care and patient authorized entities electronically.
[21] Objective: Perform medication reconciliation at relevant encounters and each transition of care.
[22] Objective: Provide summary care record for each transition of care and referral.
[23] Objective: Capability to submit electronic data to immunization registries and actual submission where required and accepted.
[24] Objective: Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission according to applicable law and practice.
[25] Objective: Protect electronic health information maintained using certified EHR technology through the implementation of appropriate technical capabilities.
Measure: Conduct or review a security risk analysis in accordance with the requirements under 45 CFR 164.308 (a)(1) and implement security updates as necessary.
_______________________________________________________________________________
Timing is Very Important
In order to maximize the potential for incentive reimbursement a physician must be able to demonstrate “Meaningful Use” of a “Certified” EHR by 2011. An average Evaluation of an Electronic Medical Record solution can take anywhere from 3 to 12 months depending on the type and size of a physician practice or group. An average full Implementation Process of an Electronic Medical Record solution can take anywhere from 6 to 12 months.
When combining the Evaluation Process with the Implementation Process it is not unreasonable to expect to take 12 to 18 months to complete the full process to the point of being able to comply with Meaningful Use criteria and apply for Medicare Incentives. A physician practice or group intending to take full advantage of Medicare Incentives should strongly consider beginning the process of budgeting for a solution and setting a start date for evaluation within the 2009 calendar year.
It is also important to note that industry wide implementation resources are scarce. Therefore, making an EHR decision sooner rather than later will ensure that a practice will be placed into the implementation queue in a timely manner and thus avoid a delayed implementation that could adversely affect a practices ability to take full advantage of Medicare Incentives.
Additional financial benefits available beginning in 2009
The Medicare Improvement for Patients and Providers Act provides immediate incentives for the utilization of e-Prescribing:
• 2% increase in Medicare reimbursements for e-prescribers in 2009 and 2010
• 1% increase in Medicare reimbursements for e-prescribers in 2011 and 2012
• .5% increase in Medicare reimbursements for e-prescribers in 2013
Physician Quality Reporting Initiative (PQRI):
On December 20, 2006, the President signed the Tax Relief and Health Care Act of 2006 (TRHCA). This Act authorizes the establishment of a physician quality reporting system by the Centers for Medicare and Medicaid Services (CMS).
PQRI establishes a financial incentive program for eligible physicians to participate in a voluntary quality reporting program. Eligible physicians who successfully report a designated set of quality measures on claims may earn a bonus payment of 1.5%.
Tax Write Off:
Currently through the section 179 tax write off, practices are able to write off up to $250,000 of software and related equipment purchased. For practices that can use this tax benefit, this clause functions as a 35% discount off of your purchase price. For example, if a practice purchased and installed $50,000 of EMR software and hardware in 2009, the practice would be able to depreciate, or write off the full $50,000 this year which translates to total cash savings of $17,500.
Malpractice Insurance Reduction:
Depending on the specialty significant reductions may be available in conjunction with an EHR implmentation.
Basic Return on Investment Opportunities
• Improved Visit Level Coding
• Better Charge Capture
• Transcription Savings
• Reduction in Labor Costs and Chart Materials
What if a Physician Practice or Group has already purchased an EHR solution?
As long as the EHR solution that is installed is “Certified” and the practice can prove “Meaningful Use” they will be eligible to receive the incentive payments outlined above beginning in October, 2011. The Bill does not distinguish between currently installed and yet-to-be-installed systems.
• Evaluate your practices HIT Strategy
• Create a Budget for the Project
• Determine a Selection and Evaluation Process
• Evaluate “Certified” Systems
• Determine Implementation Timeframe
Should a Physician Practice or Group wait until all the details are worked out and announced before initiating a selection process?
The practice is of course the best judge of their current status, but a clear provision of the stimulus package and the HIT funds to be made available, is that the practice needs to be a “Meaningful” user on a “Certified” EHR solution. This would imply the EHR solution is fully implemented and ready to meet the reporting provision required to access the incentive funds. Because the actual system selection process, implementation, training and system fine tuning requires a time commitment that is best not rushed, most experts believe that a delay in beginning the process increases the risk that the practice may not be eligible to receive incentive funds at the earliest availability.
Conclusion
There is a great deal of financial opportunity in the market today for a physician practice or group
• Medicare Incentive Schedule
• E-Prescribing Utilization Incentive
• PQRI Reporting Incentive
• Tax Write Off
• System Return on Investment
In order to be eligible for Medicare Incentives a Physician Practice must implement a “Certified” EMR, and
NextGen has been among the first group of EHR systems certified every year that CCHIT certification standards have been in existence and NextGen is committed to certification under the evolving standards of the stimulus bill.
For More Information about how NextGen and KIG Healthcare can meet you Electronic Health Records and Practice Management System needs please contact us today.
Charlie Jarvis with Newt Gingrich at the NextGen User Group 11/2009
Mr. Gingrich explains in detail how one of the best steps forward that a provider / practice can make is to become comfortable and familiar with their chosen EHR, which will deliver savings and increased productivity, but more importantly reduce errors and provide a much greater quality of patient care. Watch the video for the full story.
PIEDMONT MEDICAL CARE CORPORATION EXPANDS ITS USE OF ELECTRONIC HEALTH RECORD, PRACTICE MANAGEMENT AND NEXT MD TECHNOLOGY
American Recovery and Reimbursement Act
A top physician group pursues clinical integration plan, aims to position itself favorably for
accomplishing stimulus reimbursements.
NextGen Healthcare Information Systems, a top provider in ambulatory health care and connectivity services, announced today that Piedmont Medical Care Corp, the administrative division of the non-cardiology physician practice offices of Piedmont Healthcare, has acquired an additional 230 “bundled” NextGen Electronic Health Record and Practice Management licenses. Piedmont Medical Care Corp has been a NextGen client since 2000 starting on Practice Management and implementing Electronic Health Records in 2004, and is now implementing the NextMD patient portal as well. Piedmont states that the reason for the new purchased license and expanding NextGen services is to take advantage of the financial incentives of the American Recover and Reinvestment Act.
“We believe technology is the key to developing a truly integrated environment for care delivery,
and we are committed to pursuing a strategy of clinical integration among all physician members,”
said Ronnie Brownsworth, M.D., CEO of the Piedmont Clinic and executive vice president of
Piedmont Healthcare. “The NextGen platform is a critical component of this strategy, and it also
provides us with the functionality needed to meet meaningful use criteria and, ultimately, receive
stimulus reimbursements.”
Since instituting NextGen Practice Management, Piedmont Medical Care Corp has benefited in the following ways:
• Increased physician income and gross collections;
• Close to complete removal of mistakes and a decrease in associated costs;
• 75% decrease in patient inquiries to the central billing office;
• 70% reduction in claim denials;
• 66% decrease in the average time patients are in Accounts Receivable.
Piedmont Medical Care Corp has added NextGen Electronic Health Records to classify specific drug-to-drug interactions and boost physician attentiveness of timing for vital screenings .The group is also utilizing practice and physician feedback reports within NextGen’s Health Quality Measures Portal
to examine performance alongside Bridges to Excellence measures for enhanced patient care and
Electronic Health Record documentation procedures.
“Federal incentives coupled with our push for clinical integration has created a ‘perfect storm’ for
PMCC,” said Berney Crane, CEO of PMCC. “It is critical for us to jump on this opportunity and take
a leadership position in the market. We feel that NextGen Healthcare provides the platform needed
to do that.”
'Meaningful use' No Mystery, Experts Contend Mark Leavitt, MD, president and CEO of the Certification Commission for Health Information and Technology.
If physicians delay their acquisition of an Electronic Health Records until Congress issues a definition of "meaningful use," they're wasting significant time.That's the opinion of healthcare IT experts who often take the temperature of the Capitol Hill bureaucracy.
The American Recovery and Reinvestment Act will allocate $20 billion for directly to providers for funding and incentives who implement EHR and use them in a "meaningful" way starting in 2010. However, the act leaves it up to the Health and Human Services Secretary to define what kinds of practices constitute "meaningful use," and some experts say that uncertainty built into the bill could actually delay the extensive purchase and implementation process.
"Just buying a certified EHR is not meaningful use," explained Mark Leavitt, MD, chairman of the Certification Commission for Healthcare Information Technology. But, he added, there's really no question about what meaningful use will suggest in the near future.
"The major parameters are actually written into the bill," said Leavitt, one of many of Healthcare IT insiders who recently testified on meaningful use in front of the National Committee on Vital and Health Statistics. "It has to be a certified EHR, it has to include e-prescribing, it has to be able to exchange information and it has to be able to report quality data. I'm not sure if we have to know more than that - if you are a provider - to be able to make a technology investment now," he confirmed.
Addressing at the New England HIMSS Public Policy Forum last week, former e-Health Initiative CEO Janet Marchibroda confirmed Leavitt's assessment and said she anticipating the definition of meaningful use will transform over time.
"You can't set the bar too high (to start)," she said. "You need to have something that's achievable for small physician practices, and then we can ramp it up over time."
When asked if providers, in particular, should wait on their acquisition of an EHR, Marchibroda said there's not one reason to wait. "Three months ago, it was a more difficult question," she explained. "We'll see a draft of meaningful use in a month, and a final definition in two months. We are literally weeks away... I don't think there will be any surprises."
Speaking at the same meeting, Dave Roberts, HIMSS' vice president of government affairs, was even more insistent. "This is the time to get started with whatever you're doing," he said. "Don't wait until you know all the details."
Like Leavitt, Roberts said the significant points of "meaningful use" are known and explained that at HIMSS09 in Chicago, a representative from the Congressional Budget Office associated "meaningful use" with Stage 4 of the Electronic Health Records implementation model. Roberts said he assumes a very straightforward definition to be in place.
"We believe the bar should be set fairly low initially and raised over time," he noted. For instance, the capacity to exchange information between two different providers implies the reality of a health information exchange. Since some physicians may not be in a region in which a useful exchange is in place by 2010, it would be difficult to demand that in the definition.
ARRA will provide federal incentives of up to $44,000 per provider over the next five years. However, the main benefits will come in the first years, meaning that the physicians who can show meaningful use the earliest, the larger the incentive. The initial incentives will be rewarded in 2011 based on 2010 performance. By 2015, providers who are not utilizing certified EHRs could be punished by Medicare and Medicaid.
Govt releases much anticipate definition of 'meaningful use' The government delivered on December 30th the much anticipated definition of “meaningful use” of electronic medical record technology, and it came dispersed in about 700 pages of content and proposed regulations.
The ability to exchange health data between physicians, security of that information, standard formats for clinical synopsees and prescriptions and standard terminology to describe clinical issues, procedures and trials are part of the 700 pages.
A proposed rule issued by CMS summarizes future provisions governing the Electronic Health Record incentive programs, including defining the main concept of “meaningful use” of Electronic Health Record technology. An interim final regulation (IFR) released by the Office of the National Coordinator of Health Information Technology (ONC) sets preliminary standards, implementation requirements, and certification criteria for Electronic Health Record applications. Both of these topics and regulations are open to public comment.
Phased approach
For providers, who’ve feared that "meaningful use" would be unattainable in 2010, the Centers for Medicaid and Medicare Services (CMS) recommends phasing the standards into three stages. "Such a phased approach encompasses reasonable criteria for meaningful use based on currently available technology capabilities and provider practice experience, and builds up to a more robust definition of meaningful use, based on anticipated technology and capabilities development," the projected rule states.
The Stage 1 meaningful use criteria concentrates on electronically capturing health data in a coded format, using that data to report key clinical conditions and sharing that data for care coordination purposes. Stage 1 also requires implementing clinical decision support tools to aid disease and medication management and reporting clinical quality measures and public health information.(A list of 25 Stage 1 criteria for eligible providers may be found here. Please let us know if you have any questions or the link does not open.)
CMS representatives recommend Stage 2 definition planned by the end of 2011 and the Stage 3 criteria planned by the end of 2013. "Our goals for “Stage 3” meaningful use criteria represent overarching goals which, we believe, are attainable by the end of the EHR incentive programs," the projected rule states.
CMS seeks comment
The Interim Final Regulation will go into effect 30 days after release, with a chance for public comment and improvement over the next 60 days. An ultimate rule will be released in 2010. A proposed rule dealing with the certification of Electronic Health Record applications is in process and is expected "soon," according to ONC representatives, resisting speculation on how the meaningful use criteria might influence products certified by the Certification Commission for Health Information Technology.
"Widespread adoption of electronic health records holds great promise for improving health care quality, efficiency, and patient safety,” said, National Coordinator for Health Information Technology David Blumenthal, MD. “The Recovery Act’s financial incentives demonstrate Congress’ and the Administration’s commitment to help providers adopt and make meaningful use of EHR technology so they can give better care and their patients’ experience of care will improve. Over time, we believe the EHR incentive program under Medicare and Medicaid will accelerate and facilitate health information technology adoption by more individual providers and organizations throughout the health care system.”
The Healthcare IT stimulus plan has allotted $17.2 billion to pay out Medicare and Medicaid providers who can demonstrate they are using certified healthcare IT "in a meaningful way." At a press conference on Dec. 30 pronouncing the proposed regulations, CMS representatives proclaimed the actual incentive rewards could vary anywhere between $14.1 billion on the low end, $27.3 billion on the high end. The actual allotted rewards, they say, depends on how many physicians decide not to participate in the voluntary program, and of those who decide to buy in, how many will be eligible for all payments.
The payments are scheduled to take effect beginning Oct. 1, 2011. Experts say physicians should not waste time getting ready because there is a lack of EHR Vendors who are qualified and support a certified EHR available to help.
Foundation for boosting quality, efficiency
Officials from CMS and the ONC for Health Information Technology said the rules and procedures set the foundation for improving safety, quality, and efficiency through meaningful use of EHR technology.
“These regulations are closely linked,” said Charlene Frizzera, CMS acting administrator. “CMS’s proposed regulation would define and specify how to demonstrate ‘meaningful use’ of EHR technology, which is a prerequisite for receiving the Medicare incentive payments. Our rule also outlines the proposed payment methodologies for the Medicare and Medicaid EHR incentive programs. ONC’s regulation sets forth the standards and specifications that will enhance the interoperability, functionality, utility and security of health information technology.”
The Interim Final Rule (IFR) issued by ONC explains the standards that must be met by certified EHR applications to swap healthcare information among physicians and between providers and patients. This early set of standards begins to define a general language to ensure accurate and safe health information exchange amongst different EHR applications. The rule explains standard formats for prescriptions and clinical summaries; standard terms to describe allergies, medications, procedures, clinical problems, and laboratory tests; and standards for the secure transportation of this data using the Internet.
Objective – Brief Overview of the ARRA as it relates to Medicaid Providers
What does the HITECH Act cover with regard to Medicaid?
The act amends Title XIX to allow for new Medicaid incentive payments to certain providers with high Medicaid volumes to cover the provider’s costs for acquiring, using, and maintaining certified EHR technology.
What healthcare providers are eligible for Medicaid Incentives under the HITECH Act?
The following providers who demonstrate “Meaningful Use” of a “Certified” Electronic Health Record (EHR)
Providers
Eligibility Requirements
Children’s Hospitals
All
+ ”Meaningful Use”
Acute Care Hospitals
10% or Greater Medicaid
Federally Qualified Health Centers
30% or greater Needy Individuals*
Rural Health Clinics
30% or greater Needy Individuals*
Non-hospital Based Professionals
30% or greater Needy Individuals*
Non-hospital Based Pediatricians
20% or greater Needy Individuals* for 2/3rd payments
*The term “needy individual” means, with respect to a Medicaid provider, an individual…
- who is receiving assistance under Medicaid - who is receiving assistance under Title XXI - who is furnished uncompensated care by the provider; or - for whom charges are reduced by the provider on a sliding scale basis based on an individual’s inability to pay
What is the extent of the financing available through this HITECH legislation?
The Bill currently provides approximately $30 billion in funds allocated for the building of Health IT infrastructure and incentives to adopt. Beyond this $17 billion is slated for physician incentives
Eligible physicians can receive up to $65,000 over a five-year period
Incentives will start in October 1st, 2011
Medicaid Incentive Schedule Per Year
How much money can an eligible provider expect to receive in Medicaid incentive payments?
These new Medicaid payments can cover up to 85% of the provider’s costs to acquire, use and maintain a “certified” EHR while demonstrating “meaningful use”.
Adequate Reporting Ability with Your EHR for Meaningful Use
OREM, UT – Eighty-five percent of healthcare providers deem their ambulatory electronic health record applications will enable them to meet the 2011 meaningful use deadlines being considered by the federal government, according to a new report from KLAS. (If you would like more information on KLAS please visit their website at www.klasresearch.com/.)However, many physicians who responded say their EHR technology lacks adequate reporting functionality.
For "Ambulatory EMR: On Track for Meaningful Use?" KLAS surveyed more than 1,400 physicians about 26 EHR vendors to review each application’s readiness to meet meaningful use requirements, based on the direction given by the federal Health IT Policy Committee in July 2009. Most surveyed deem their EMR will help them meet the planned government requirements, with NextGen customers expressing the most confidence and SRSsoft and Amazing Charts users expressing the least.
Doctors also discussed a number of functional components that are still not up to speed. The most apparent functional areas among these discussed were EMR reporting capabilities, patient’s ability to access medical records and sharing clinical data.
"Reporting will obviously play a vital role in a provider's ability to meet the proposed meaningful use standards, yet more than 17 percent of providers say reporting is difficult or impossible with their current tools – and another 24 percent report needing specific technical expertise to manipulate the tools provided," said Mark Wagner, director of ambulatory research for KLAS and author of the report.
"To help their clients meet the substantial reporting requirements for meaningful use, many vendors will need to increase the number and complexity of their canned reports, provide a stand-alone reporting application or add a third-party tool that can pull the required data," Wagner added.
NextGen’s reporting capabilities have always and will continue to be one of the leaders in the industry. From the reports that come with NextGen to “custom” Crystal reporting capabilities KIG Healthcare Solutions can assist your practice in reporting and sharing clinical data.
Vendors highlighted in the new KLAS ambulatory EMR report were Allscripts, Amazing Charts, Aprima (iMedica), athenahealth, Cerner, CHARTCARE, DoctorsPartner, eClinicalWorks, Eclipsys, e-MDs, Epic, GE, gMed, Greenway, HealthPort, Ingenix, LSS, McKesson, MED3000, MedcomSoft, NextGen, PracticeOne, Praxis, Sage, Sevocity and SRSsoft.
Helping Physicians Understand the Stimulus Programs
For all the discussion recently about meaningful use and anticipation about the increase in new deployments of electronic health records, apparently many of busy practices are still in the dark about much of what is being talked about.
While a new a report states that about 4 in 10 practices report using a form of electronic health records or electronic medical records, many vendors who witness to the day to day in the physician’s practices say most doctors--especially those in 1-5 doc offices-- are still far away from using electronic records in accordance to the fed's recommendations of "meaningful use" criteria.
Most physicians have not been following the information in recently as the federal government and its variety of advisory committees have been defining meaningful use regulations of the $20-billion plus American Recovery and Reinvestment Act. And many doctors have not given much attention that near-final meaningful use recommendations were given by the Centers for Medicare and Medicaid Services and the Office of National Coordinator for Health IT just before the end of 2009.
Those physicians---thousands of them who are caring for patients in their one-to-five physician practices—might have seen or heard something about the plans to incentivize (and eventually penalize slow evolving) physicians for their use (or non-use) of electronic health records, but they have not had time monitor the unfolding requirements.
"Doctors still don't really understand the basics" of what electronic health records applications do, let alone the government regulations that will be rolled out from 2011 to 2015 to pay physicians to deploy these applications and use them in more and more complex and meaningful ways, said Scott Decker, NextGen president.
"There's a big need for education" among practices, he said. That's a major reason why NextGen decided to set up meaningful use resources and a physician forum to help doctors, he said.
The resources can help any practice in many ways, but especially to the practices that have not begun their electronic health record discovery process, he said.
As more and more offices implement these systems, the difficult issue will be the electronic sharing of patient’s info among providers and patients.
"We've got a client base of thousands of practices and tens of thousands of doctors, but less than 5% share this data with patients, and even fewer share the data with other physicians," he said.
Being that the electronic transmission of patient info--including offering patients with their electronic records--are included the near-final meaningful use criteria physicians will have to comply with to qualify for stimulus funds the next couple of years, that's going to be another broad topic that doctors will need assistance with and KIG and NextGen can help.
More and more, electronic health records (EHRs) are showing up in medical practices. That’s according to a recent survey released by the National Center for Health Statistics (NCHS).
The challenge for legislatures is formulating a plan on how to encourage EHR adoption while not making providers’ lives too difficult and, at the same time, responding swiftly and effectively to problematic issues encountered along the way.
According to the NAMCS, Centers for Disease Control and Prevention, NHCS’s National Ambulatory Medical Care Survey “is an annual nationally representative survey of patient visits to office-based physicians that collects information on use of EMR/EHR.”
Their findings, in the graph below, indicate that over the 10 years a steadily increasing number of providers are implementing EHRs into their offices.
In short, “according to combined data from the 2008 surveys . . . 41.5 percent of physicians reported using all or partial EMR/EHR systems (not including systems solely for billing) in their office-based practices. . . . According to preliminary estimates from the 2009 mail survey, 43.9 percent of the physicians reported using all or partial EMR/EHR systems (not including systems solely for billing) in their office-based practices. About 20.5 percent reported having systems that met the criteria of a basic system, and 6.3 percent reported that of a fully functional system.”
Those statistics may not excite the more zealous proponents of healthcare IT, but they clearly represent advancement.
But one potential difficulty may be that federal officials are stacking up too many expectations, in the form of the recently proposed “meaningful use” regulations, on physicians who would like to ramp up their use of health IT.
Another issue may be that legislators don’t react fast enough, or with sufficient resources, to issues such as the recent increase in possible security violations.
It helps to step back from the policy battles and look at the larger picture. According to the CDC, the EHR picture looks very good.
Providers eager to take advantage of the incentives offered through the US government's definition of 'meaningful use' of Electronic Health Records may find themselves evaluating their interactions with existing and new EHR vendors.
Revising an agreement with a vendor during the contract period can be a vital step to aligning EHR projects with federal incentives, said Jeffery Daigrepont, senior VP at Coker Group. "Many vendors offer a money back guarantee if their product does not comply with stimulus," Daigrepont said.
"Every contract should have a warranty that requires a vendor to correct defects at their expenses and under NO circumstances should you ever sign a contract without being entitled to future upgrades and new releases." NextGen EHR also offers the same ‘money back guarantee’, but because NextGen EHR is already CCHIT certified for 2011 we can assure you that you will be eligible for all stimulus fund s when they become available.
Daigrepont, who has no financial ties with any vendors, provides us with his list of four Electronic Health Record decisions to avoid:
1. Purchasing defective software
It may not be the office’s fault, but it's the office’s problem. Defective software can range from minor glitches to major liabilities. Most defects can be fixed, or workarounds introduced. However, in some cases where the defects can cause a threat to security or patient safety, or a liability to the practice, the defects MUST be addressed at once and/or use must be ceased -- just as Toyota has had to do with their automobile’s sticking accelerators.
2. Purchasing non-compliant software
Your entire practice is expecting the software to comply with national standards or federal regulations, but the vendor does not develop their product in agreement to these guidelines. In the instance of stimulus incentives, being ineligible becomes a possibility. Moreover, penalties for not implementing certified EHR could be enforced.
3. Not being able to see the writing on the wall
Your system is up and running, working and meeting the needs of the practice, but your vendor has discontinued the product and is no longer creating updates and new versions. In short, you're are a sinking ship. Not being proactive or refusing to recognize the obvious is only delaying the inevitable reality of having to terminate and replace your EHR system.
4. Going live with an incomplete application
The pressure to go live on a new application is often pushed by a vendor who is trying to experience revenue by using up the hours in the agreement so they can get to the next implementation. The application (in some cases) was not properly analyzed before going live. As a result, the users or doctors get first struck by a poor experience or even worse, backward slide starts to occur. This can be dodged by implementing an easy plan called "DBVT" (Design, Build, Validate, Test). For instance, design your order applicatoin, build your order application, validate the new application with end users, and test the application with end users. This plan of attack will help you steer clear of going forward with an incomplete software design.
According to HIMSS survey docs are trending towards EHR
Poll: Meaningful use driving spending in 2010
ATLANTA – The discoveries of the 21st Annual Healthcare Information and Management Systems Society (HIMSS) Leadership Survey reveal encouraging findings in the year ahead, indicating growth in health IT spending as physicians strive to meet the legislator’s meaningful use guidelines.
The poll, which comes on the end of the successful HIMSS10 conference and meetings in Atlanta, reveals that large numbers of hospitals and doctors, perhaps extremely inspired by the recovering economy, plan to boost their operating expenses in order to meet the guidelines for financial incentives outlined by the ARRA.
Of the 398 surveyed, 72 percent responded that they will expect their IT budgets to multiply. In 2009, just 55 percent of the people surveyed could say they expected the increase in the budget. More importantly, almost 50 percent of those surveyed who said they expect their budgets would multiply in 2010 responded that meaningful use would be a major factor.
Another important percentage was the 42 percent of poll that said meeting meaningful use guidelines was their "single IT priority" for 2010 and 2011. When surveyed to classify their practice’s main clinical IT focal point, 35 percent responded it would be to make certain their practice has a fully implemented electronic medical record (EMR) solution in up and running, and 27 percent responded they would be focusing on implementing a computerized provider order entry (CPOE) system.
Barry P. Chaiken, MD, HIMSS board chair, who headed up the annual HIMSS conference, was quoted to say, "Many healthcare executives are paying attention to the improving financial picture, evaluating their systems and starting to make investments. A year ago, spending was down and hospitals were feeling pressure, but the stabilizing of the economy and the ARRA meaningful use provision has provided an incentive for making healthcare IT investments."
The influence of meaningful use guidelines were found in other responses as well. 38 percent surveyed named government regulations as the trade issue they felt would have the greatest influence on healthcare in 2010 and 2011; in 2009 that figure was just six percent.
Other conclusions from the HIMMS Leadership Survey:
• Sixty-six percent of practices reported plans to boost the amount of IT employees
• Forty-eight percent surveyed responded they have a fully implemented Electronic Medical
Record in at least one location, compared to 41 percent in 2009.
• Twenty-two percent surveyed they have a fully functional EMR in their entire organization,
up from 17 percent in 2009
• Thirty-two percent have started the installation process of EMR in at least one location
• Twenty-four percent said lack of financials would be the greatest barrier to prosperous
healthcare IT installation at their practice
NextGen Healthcare Information Systems President, Scott Decker, speaks to Dr. Eric Fishman about the company’s recent initiatives and plans for the future.
Contact us today to set up a free demonstration of NextGen, and let us show you how we can help.
_______________________________
Are you taking advantage of PQRI?
Here is a testimonial from Mark Rosenburg the Executive Director of Barnet Dulaney Perkins Eye Center about his practice's million dollar revenue increase. With the NextGen EHR you can report all PQRI measures and experience a revenue increase for your practice.
