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There Are Some Things You Just Can’t Do Without an EHR

Posted on March 24, 2015 I Written By

The following is a guest post by Tom Giannulli, MD, MS, Chief Medical Information Officer, Kareo. Follow and engage with him on Twitter @drtom_kareo or @GoKareo.
Tom Giannulli - Kareo EHR
Over the past two years, there has been a lot of talk about a big EHR switching trend. Some of this has been because of Meaningful Use, and some of it has been because of market changes. There are simply more options today if you are unhappy with your current EHR.

Surveys show that many physicians are frustrated with the cost or functionality in their EHR, which has prompted considering a switch. There is also frustration with too much third party interference and regulation. Despite some of these challenges, one thing is clear. Most physicians believe EHRs improve care, reduce errors, and improve billing.

What sometimes gets left out are the other opportunities created by using an EHR. Some of these are new revenue sources that might be impossible or very hard to access without one. Here are a few examples, but certainly not the only ones.

Medicare Programs
There are some new codes that have come out in the last two years for services that are revenue generators, but you really do need an EHR to manage them. The first is transitional care management (TCM). While TCM doesn’t require you to use an EHR, the complexity of it makes it hard to do without one. The ability to easily put in your notes and set reminders for needed follow up makes managing TCM much easier. With reimbursement ranging anywhere from about $100 to over $200 per patient, this can be a great opportunity for providers who see many patients who need post hospitalization follow ups.

The other Medicare program is newer and does require the use of a certified EHR. It is the Chronic Care Management (CCM) code that came out this year. The reimbursement is about $42 per patient and can be billed once a month. The requirement is that the patient has two or more chronic conditions that are expected to last at least 12 months or until the patient’s death. Clinical staff must spend at least 20 minutes performing CCM services for the patient each month that the code it billed. The services are non-face-to-face and direct supervision is not required, which means that nursing staff or non-physician practitioners can render CCM even if the physician is not in the office. Again, if your practice sees a lot of patients with chronic health problems, this can be a great way to add revenue by using nursing or mid-level staff.

Affordable Care Act Opportunities
By now I hope everyone knows that preventive care services are covered with no copays or deductibles. What many providers still aren’t very aware of are the other types of programs that are now covered by insurance that can be great revenue generators. While they don’t require an EHR, this is another area where using an EHR makes running these programs much easier. The two programs that make a lot of sense for primary care providers and specialists who see patients with certain types of qualifying conditions are group visits and weight loss programs.

With group visits, the practice identifies a group of patients who have a similar, chronic condition that requires frequent visits. You can do this using your EHR (it would be tough using paper charts). Some examples include HIV, chronic pain, COPD, and hypertension. Vitals are done individually as patients arrive and then the whole group spends the rest of the 1.5 – 2 hour visit together with the provider. Once a group visit is completed, each patient’s insurance is billed for the appropriate E&M code for their individual situation. The ability to use templates and copy note features in the EHR can make documenting after the group visit much faster and easier than it would be if done by hand.

For patients with certain conditions, a weight loss program may be mostly or fully covered by insurance like preventive care. The great thing about this is that it can be as simple or complex as you are willing to manage. You can do simple nutritional counseling and weigh-ins or go for a fully formed program through a third party that includes food and supplements. Again, using an EHR makes it much easier and faster to manage and track multiple follow up appointments, set reminders, and copy notes and simply update them each time. You can even have a group visit component!

The key to all of these opportunities is that an EHR helps reduce the complexity of managing the requirements and helps insure that you can quickly and easily show accurate, thorough documentation to payers. Without an EHR, these revenue generating programs would simply seem too difficult to manage. In a time when every penny counts, you can’t ignore opportunities like these.

Kareo, the leading provider of cloud-based software and services for independent medical practices, is a sponsor of EMR and EHR. Find out more about Kareo’s award-winning solutions at

Unlocking EHR Data to Accelerate Clinical Quality Reporting & Enhance Renal Care Management

Posted on March 18, 2015 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The following is a guest blog post by Christina Ai Chang from DaVita and Vaishali Nambiar from CitiusTech Inc.
Christina and Vaishali
When healthcare providers began achieving Meaningful Use (MU) — the set of standards, defined by CMS, that allows for providers to earn incentive dollars by complying with a set of specific criteria — a health IT paradox emerged. The reports required for incentive payments are built on data the EHR captures, however, EHRs don’t typically have built-in support for automated reporting. This places a time-intensive manual burden on physicians as they report for MU quality measures. In other words, a program intended to increase the use of technology inadvertently created a new, non-technical, burden. The need to manually assemble information for reports also extended to the CMS Physician Quality Reporting System (PQRS) incentive program. As with many providers, EHR reporting shortcomings for these CMS programs severely impacted the kidney care provider, DaVita Healthcare Partners, Inc. (DaVita).

As one of the largest and most successful kidney care companies in the United States, DaVita has constantly focused on clinical outcomes to enhance the quality of care that it provides to its patients. In its U.S. operations that include 550 physicians, DaVita provides dialysis services to over 163,000 patients each year at more than 2,000 outpatient dialysis centers. These centers run Falcon Physician, DaVita’s nephrology-focused solution that largely eliminates paper charting by capturing data electronically and providing a shared patient view to caregivers within the DaVita network.

Falcon Physician serves DaVita very well in its design: renal-care specific EHR capabilities and workflows to support patients with chronic kidney disease (CKD). However, federal incentive programs like MU and Physician Quality Reporting System posed their own challenges. Falcon, like most EHRs, did not have the sophisticated data processing and analytics capabilities needed to meet the complex clinical quality reporting mandated by these programs. With limited built-in support for automated reporting, DaVita physicians had to manually calculate denominators and complete forms for submission to CMS for quality measures reporting, typically taking five to six days per report. With the organization averaging 800 encounters per physician each month, this placed a highly time-intensive and manual burden on physician offices. In addition, manual reporting often resulted in errors, since physician offices had to manage ten or more pieces of data to arrive at a single measure calculation, and do that over and over again.

The Need to Automate Reporting – But How?

To address the time and accuracy issues, DaVita recognized it would need to unlock the data captured by the EHR and use an effective data analytics and reporting tool. To begin evaluating options, the organization put together a team to explore two potential paths: creating a proprietary reporting capability within the EHR, or integrating a third-party solution.

It became clear that proprietary development would be challenging, mainly because of the technological expertise that would be needed to build and maintain sufficiently advanced analytics capabilities. It would require special skillsets to build the rules engine, the data mapping tools, and the visualizations for reporting. In addition, DaVita would need to maintain a clinical informatics and data validation team to assess the complex clinical quality measures, develop these measures, and test the overall application on an ongoing basis. Further, DaVita would also need to get this functionality certified by CMS and other regulatory agencies on a periodic basis.

While looking for a third-party solution that could easily integrate with Falcon, DaVita came across CitiusTech, whose offerings include the BI-Clinical healthcare business intelligence and analytics platform. This platform comes with pre-built apps for multiple reporting functions, including MU and PQRS. Its application programming interface (API) simplifies integration into software like Falcon. The platform aligned closely with DaVita’s needs, and with a high interest in avoiding the expense, time and skillset hiring needed to build a proprietary reporting function, the organization decided to move forward with third-party integration.

Accelerated Implementation and Integration

Implementation began with a small proof of concept that delivered a readily scalable integration in fewer than six weeks. DaVita provided the database views and related data according to the third-party solution’s specifications. This freed DaVita not just from development, but also from testing, installation, and configuration of the platform; thereby, saving time and money, and creating a more robust analytics platform for DaVita’s physicians. In the end, going with an off-the-shelf solution reduced implementation time and cost by as much as two-thirds.

Integration with the third-party platform enabled DaVita’s Falcon EHR system to completely automate the collection and reporting of clinical quality measures, freeing up tremendous physician time while improving report accuracy. With additional capabilities that go beyond solving the reporting problem, the new solution translates EHR data into meaning performance dashboards that assist DaVita physicians in the transition to pay-for-performance medicine.

The platform with which DaVita integrated is ONC-certified for all MU measures for eligible professionals (EPs) and eligible hospitals (EHs). Falcon was able to leverage these certifications and achieve both MU Stage 1 and Stage 2 certification in record time. This also enabled Falcon to accelerate its PQRS program and offer PQRS reporting and data submission capabilities.

Automated Reporting and Dashboards in Action        

Today, hundreds of DaVita physicians use the upgraded EHR, and the integrated business intelligence and analytics function eliminates the need for these doctors to perform manual calculations for MU and PQRS measures. Where manually creating reports used to take five to six days, pre-defined measure sets now complete reports and submit data almost instantly.

With the manual reporting problem solved, DaVita’s physicians now take automation for granted. What they see on a daily basis are the quality-performance dashboards. These dashboards give them a visual, easily understood picture of how they’re doing relative to quality measures, and the feedback has been extremely positive. Many powerful reporting features are highly appreciated, such as key measurements appearing in red when it’s time to change course in care provision to meet a particular measure. Such information, provided in real-time with updates on a daily basis, has led to very strong adoption of the new reporting capabilities among physicians.

Currently, DaVita is working to develop a benchmarking tool that can rate all physicians within a location. The focus on quality-measurement rankings relative to their peers, with drill-downs to specific indicators such as hypertension and chronic kidney disease progression, will allow physicians to focus on enhancing care delivery.

Unlocking data located in the EHR has helped DaVita comply with MU and PQRS. In the coming years, the upgraded EHR will help physicians comply with evidence-based guidelines and optimize increasingly complex reimbursement requirements.

Healthcare Interoperability in Action

Posted on March 16, 2015 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

100+ live clinical information systems sharing health data at HIMSS makes for a good headline. What’s not clear to me is how this is really any different than the past 2-3 interoperability showcases at HIMSS. Don’t get me wrong. I love that these systems can interoperate, but they’ve been able to interoperate for a long time. At least that’s what you believe from the headlines coming out of every interoperability showcase at HIMSS.

I’m hoping to learn at HIMSS why there’s such a wide gap between interoperability between systems at HIMSS and the real world. Is it a lack of desire on the part of healthcare organizations? Is it that the sandbox environment is much simpler than trying to share data between EHR systems which have had a series of customizations as part of every EHR implementation?

I also think there’s a major gap between hospital interoperability and ambulatory care. Most doctors I know aren’t working on interoperability at all. They wouldn’t even know where to start. They just assume that their EHR vendor is going to eventually solve that problem for them. Sure, they wish that it would happen, but I don’t think doctors feel like they have any power in making it a reality. I’d love to hear if you think that’s a good or bad assumption on the part of doctors.

Talking HIMSS interoperability showcase headlines, how much more powerful would it be to have the headline say “100s of live clinical information systems sharing data throughout the country.” 100s still feels weak, but at least we’d be talking about interoperability in a real life situation and not just the perfectly designed test systems.

I guess I’m still interested in “A little less healthcare interoperability talk…a lot more action.

Meaningful Use Stage 3 to Come Out Before HIMSS15?

Posted on March 11, 2015 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Madelyn Kearns from Medical Practice Insider is reporting that we might see meaningful use stage 3 regulations before HIMSS. Here’s the exact quote from Robert Anthony, deputy director of CMS’ quality measurement and health assessment group:

“We will have two regulations that will come out in time to discuss meaningful use”

It’s hard to imagine that one of these 2 regulations will not be meaningful use stage 3. No doubt CMS and ONC will want to get some feedback from the HIMSS community on meaningful use stage 3. What better place than at the conference?

Madelyn aptly points out that Robert Anthony already has one session scheduled at HIMSS to discuss the meaningful use stage 3 requirements. I have a feeling that is going to be one of the really well attended sessions. Especially if the MU stage 3 rule does come out before HIMSS.

I realize that CMS is bound by laws on when they can announce the various rules and regulations, but I hope they’ve planned out the timeline better than they’ve done in the past. My colleague Neil Versel at Meaningful Health IT News has regularly pointed out how the rules always seem to go public on a Friday. He’s hypothesized that it was the case that they were trying to hide something. I think that’s true for many Washington news stories, but I think it was coincidence in meaningful use’s case.

Even worse than a Friday is the Friday before HIMSS. Talk about ruining the weekend before HIMSS. Although, if I remember right one time they announced the rule in the middle of HIMSS. I remember meeting with a number of EHR vendor’s government relations people who were grumbling about the late night reading of the meaningful use rule that they’d be consuming all night in the middle of the craziness of HIMSS.

Hopefully CMS has learned from past experience and has planned properly to be able to announce the meaningful use stage 3 rule well before HIMSS. Doing so will give people time to look over the rule so they can have a meaningful discussion of the rule at HIMSS as opposed to some frenetic review of what’s been proposed.

Either way, I’m very interested to see what meaningful use stage 3 will look like. My prediction is that it won’t be dramatically different from stage 2. It will be more of the same with maybe 1-2 additions. It’s too bad, because I’d still love to see them blow up meaningful use. Every doctor I know would love to see that as well. Instead I think we’ll be saying “more of the same.”

Healthcare IT and EHR Jobs

Posted on March 9, 2015 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

It’s been a while since I features some of the healthcare IT jobs we have available on Healthcare IT Central. For those not familiar with Healthcare IT Central, it’s the leading healthcare IT Job board with well over 23,600 registered job seekers and approximately 12,000 active healthcare IT resumes in our job database. It’s a fantastic resource for human resource organizations across healthcare that are trying to fill their healthcare IT jobs. Many HR organizations in healthcare haven’t created a great ability to fill skilled EHR and healthcare IT jobs, so we’re happy to provide them a highly focused resource.

For those seeking out healthcare IT or EHR jobs, all of our services are free. You can signup up for free, upload your resume so it’s searchable by potential employers and you can search our healthcare IT jobs. We also do a weekly healthcare IT jobs newsletter.

Here’s a look at a few of the companies who have recently posted jobs along with the list of healthcare IT jobs they’ve posted:

Those are some of the really great healthcare IT companies that are hiring right now. You can search of other companies and positions. We hope this helps those employers who are searching to fill healthcare IT jobs and those professionals who are searching for the right healthcare IT position as well.

Can An EMR Focus on Patient Care in the Current Reimbursement Environment?

Posted on March 6, 2015 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In response to a discussion I was part of on LinkedIn, Hirdey Bhathal, CEO of Zibdy Health, offered these interesting comments:

In your comment above you say “Doctor’s are eager to improve revenue”, “clinically based reimbursement” and “emphasizing the clinical documentation that needs to be the base line for billing”….Given that how can a EMR even try to focus on patient care? Two workflows are very different and probably mutually exclusive or very difficult to bring together with any degree of success. In a situation like that a new vendor like practice fusion or any other will be forced to comply with revenue needs otherwise no provider will adopt them. This is the first feature any EMR company sells.

Are quality patient care and quality reimbursement mutually exclusive in an EHR?

I think it’s a bit much to say that they are mutually exclusive. I think you can have both. However, I think that very few EHR vendors have both right now. Hirdey is absolutely right that no doctor would buy an EHR if they didn’t take care of the revenue needs of a practice. That is the first feature that most doctors look for when looking at EHR software.

As in most parts of life, you get what you pay for. Doctors are willing to pay for something that will increase their revenue. That’s why the EHR incentives worked so good (even if it’s fuzzy math). They saw some government money and so they adopted EHR to go after the money. I can’t remember someone ever asking if the EHR would make them more effective clinicians. I can’t remember them asking if the EHR would help them provide better patient care.

It’s kind of sad thing that are reimbursement system is so disconnected from the quality of care a doctor provides. The good news is that now that reimbursement is tackled and meaningful use is tackled, I have hope that EHR vendors will start to differentiate themselves from other EHR vendors based on their clinical abilities.

What do you think? Are we heading for a new era of EHR that’s more focused on clinical and patient outcomes and less on maximizing reimbursement? Or at least that we’ll see both?

Parkinson’s Disease and Health Data: A Personal Story

Posted on March 5, 2015 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

For 20 years, I’ve been writing about clinical data management, analytics and what has now come to be known as Big Data. Like everyone else who follows this sector, I’ve been exposed to many examples of brilliant thinking about leveraging health data, and of late, a growing number of examples where data analytics has improved care and saved lives.

I’ve also reported on dozens of notable case studies in which combing EMRs for telltale signs of disease has resulted in finding dangerous or even life-threatening conditions, including heart disease, diabetes and to a more limited degree cancer. What’s even more remarkable is that we’re likely to see the list of conditions detectable by data analytics expand greatly, particularly if we make smart use of the growing flood of mobile health data.

The problem is, we’re still extremely far from achieving universal health data interoperability, and no amount of inspiring speeches by HIT thought leaders or Congressional bellyachers will achieve this goal on their own. We need a shift comparable to cultural transformation that fueled the astonishing progress of our space efforts. (Maybe someone should claim that the Russians are ahead of us in the interoperability race — we can’t let them Russkys achieve national health data interoperability before we do, durn it!)

And none of this will help me get the last few years of my life back.

You see, while the diagnosis hasn’t been all-out finalized, it appears that I have a case of early-onset Parkinson’s Disease. I won’t bore any clinicians with a detailed description of the illness, but suffice it to say that it’s neurological in origin, potentially disabling and at present, uncurable and unstoppable.  I can probably still live a good life, particularly if I respond well to standard drugs, but all told, this thing is a major buzz kill.

I’ve had signs and symptoms that fit the diagnosis for at least a couple of years, and I dutifully reported them to the caregivers I saw. That included several encounters with doctors associated with the large, high-quality health system which serves the region where I live.  The health system providers entered the symptoms into their jet-fueled Epic EMR, but it seems that despite that, they never put two and two together.  (And as is still the norm, the data gathered at PCP visits has been in no way connected to the data living in the hospital Epic system.)

Fortunately, picking up on the earlier signs of Parkinson’s — if that is indeed my condition — wouldn’t have done anything to slow the progression of the illness. (If I had a malignant cancer, of course, this would be a different story.)  But heaven knows I would have had the clarity I needed to make good self-care choices.

For example, I could have seen physical therapists to help with growing muscle weakness, occupational therapists to help me adjust my work style, joined patient groups to gather support and volunteered for clinical trials. (I live in the DC metro, not too far from NIH, so that may well have been an option.) And most importantly, as I see it, I wouldn’t have had to live with the vague but growing dread that something was Just Not Right for years.

Because I’m not a clinician, I’ll never know how likely it is that I could have been diagnosed earlier if all my caregivers had all of my health data.  But I’m confident that interoperability and the accumulation of population data will help with earlier diagnosis and treatment of many unpleasant, disabling or even fatal conditions.

So when you go about the business  of improving data analytics tools and interoperability, mining population health databases for trends and leveraging mHealth to improve chronic disease management, I invite you to think of me — not a tragic figure by any means, but someone who’s counting on you to keep connecting the dots.  Never doubt that the human value of what you do is extraordinary, but never forget that real people are waiting in the wings for you to supply insights that can give them their life back.

Posters Flame ONC Comments

Posted on March 3, 2015 I Written By

When Carl Bergman isn't rooting for the Washington Nationals or searching for a Steeler bar, he’s Managing Partner of, a free service for matching users and EHRs. For the last dozen years, he’s concentrated on EHR consulting and writing. He spent the 80s and 90s as an itinerant project manger doing his small part for the dot com bubble. Prior to that, Bergman served a ten year stretch in the District of Columbia government as a policy and fiscal analyst.

Someone at ONC who has to read public comments deserves a break. They’ve been flamed.

ONC just released the public comments on its 10 year Interoperability Plan. Many of the posts are from stakeholders who provided careful, point by point comments. These often represent greatly divergent views. However, these commenters have one thing quite solidly in common. They’ve read the plan.

Not so, many others who skipped the boring reading homework. They just dumped on it with one theme: The federal government has no business getting its hands on my medical records! There are dozens upon dozens of comments on this theme. They’re irate, angry and often vituperative – to say the least. The fact that nothing like that is in the plan doesn’t stop them from believing it and roundly denouncing it.

Where did all these folks get this notion? From what I can tell, two sources made the inductive leap from practioners sharing EHR records to the feds wanting to know about your lumbago.

One was the Citizens Council for Health Freedom, which issued an August 14, 2014 press release saying:

Our government is funneling billions of dollars into systems that will dump all of our private medical records into one giant hub—accessible by many,” said CCHF president and co-founder Twila Brase. Doctors and nurses who have already started using these systems are not convinced that they are ready for use or even necessary. The government is touting these procedures as ways to streamline patient care, but they’re actually an attempt to capture and store Americans’ private medical data and share it with agencies that have nothing to do with health care.

The release then urged readers to comment on the plan.

Brase cites no sources in or out of the plan for her observations or conclusions.

The other source was Tammy Bruce. On December 14, 2014 she wrote:

Your personal healthcare information will be shared with an astounding 35 agencies (at least), offices and individuals including the Department of Defense, NASA, the Federal Trade Commission, the Department of Agriculture, the Department of Labor, the Federal Communications Commission, the HHS assistant secretary for legislation, the HHS office for civil rights, the HHS office for the general counsel, the Office of Personnel Management, the Social Security Administration, the Department of Justice and the Bureau of Prisons.

Clearly, this is meant to establish the fact that every federal agency will be participating in this scheme and will have access to your health information. Not only should this be anathema to every American on principle alone, but having all of our personal information available in the cloud also poses ridiculously obvious general security threats to our personal security.

She also urged readers to comment about the plan.

Again, no proof, no cites, just assertions and conclusions.

I don’t have anything to say about their claims, other than this. Our open political discourse means that those who read posts have to carefully sort out thoughtful, even if misinformed, opinion from dross. Pushing phony claims for whatever reason just makes it all the more difficult. Whoever at ONC has to slog through the dross in these comments has my sympathy.

Insightful Revenue Cycle Stats and Charts

Posted on March 2, 2015 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

It never ceases to amaze me how many opportunities there are in medical practices to improve their revenue cycle management. You’d think we’d have solved this problem, but there is still so much opportunity to improve a practice’s revenue.

With this as the premise, I was interested in the revenue cycle management (RCM) survey report which offers up a number of stats and charts on such an important topic for practices.

Here’s one example chart from the report:
Percentage of Practices that Automate Revenue Cycle Management Chart

The thing about this chart that stands out for me is that almost all of them hover around 50% adoption. Some might say that this is pretty good adoption of these technologies. I see it as a huge opportunity for the other 50% of practices to adopt much of this technology.

The one that caught my eye the most is the “automated eligibility-inquiry checks.” Since reading Vishal Gandhi‘s posts on EMR and HIPAA, I’m a real convert to the importance of high quality, real time eligibility checking. Take for example his post on “The Eligibility Verification Time Suck” and “How Does a Practice Deal with All These High Deductible Plans?” This is a big deal for a practice’s revenue and is likely going to only get bigger as reimbursement continues to evolve.

There’s a lot more in the RCM survey report. Check it out and see how your practice can benefit from better revenue cycle management.

Is the Concierge Model A Real Option for Providers?

Posted on February 25, 2015 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This article last month in Crain’s New York Business talks about the pressures that primary care doctors are facing and how those financial pressures are getting many of them to try cash-only or concierge practices. Here’s an excerpt from the article:

To stave off the pressures prompting many physicians to sell their practices to hospital systems, Manhattan internist Peter Bruno has tried a number of creative solutions. They have ranged from forming a now-disbanded group practice with 60 colleagues to his ongoing strategy of working at a nursing home one day a week to supplement his income in his current solo practice.

With reimbursements dropping, Dr. Bruno made the bold move in July of converting his six-employee private practice on East 59th Street in Manhattan to a hybrid concierge model. In concierge care, patients pay an annual fee or retainer to get more immediate, customized care. Hybrid practices treat both concierge and traditional patients. He worked with SignatureMD, a Santa Monica, Calif.-based network that assists physicians in doing so.

I don’t think we need to cover the financial realities of being a solo physician here. You’re all to aware of the challenges. However, I’m interested to hear what you think about the potential for the concierge model of medicine for primary care doctors? Is that an option for most primary care doctors?

I ask this because I’ve seen concierge medicine work in the rich areas (the above case is Manhattan for example), but I have yet to see it really work in poorer areas. If we’re shifting to concierge medicine, what does that mean for the poorer areas of the country?

Here in Las Vegas, they have an interesting hybrid model that they’re trying where concierge medicine is part of the insurance plan. In fact, it could be part of the insurance plan your employer provides. I just signed up for the plan, so we’ll see how it goes.

I’m also watching how the EHR market is adapting to this trend as well. Over on EMR and HIPAA I wrote an article titled “An EHR Focused On Customer Requests, Not MU” which talks about what an EHR would look like that was just focused on patient care and how Amazing Charts was offering that product.

Just today SRSsoft announced their new SRS Essentials product that’s a non-MU EHR as well. Although, they offer an interesting wrinkle that allows their SRS Essentials customers to move up to an meaningful use certified EHR should they decide they later want to take part in meaningful use (or whatever that program eventually becomes).

Of course, SRSsoft focuses mostly on the specialty market and not general medicine. Although, maybe this physician focused EHR product will be of interest to the emerging concierge and direct primary care doctors as well.

What do you think of these new models of medicine? What’s their place in the healthcare world? Where are they going in the future? Will their technology needs be different than other doctors?