My recent blog about Sandhills Pediatrics and its successful implementation of an EMR prompted, fortunately, a very intriguing comment from Chip Hart, a Director of Sales and Marketing at Physicians’ Computer Company who also maintains the blog “Confessions of a Pediatric Practice Consultant: True Stories from the land of Pediatric Practice Management.” He wrote: “I’ll spare everyone the diatribe about how ARRA deals with pediatricians and how only about 1/2 of them qualify, as I write to make one quick statement.” There’s a story there, I thought to myself. So, being an avid observer of pediatric EMR news and views, I reached out to him to gauge his thoughts on where healthcare IT solutions fit in the world of pediatricians.

What sort of challenges are you seeing pediatric practices facing when it comes to implementing EMR systems?
“On one hand, most of the challenges they face are hardly unique to pediatrics: resistance to change, practice differences, the lack of time and resources to be trained and configured properly, poor support, etc.

“Specific to pediatrics, there are two major issues.  First, children are not simply small adults and EMRs, as a rule, are written for adult medicine. There are many pediatric-specific features and functionality that a pediatric practice needs that simply aren’t met by your large, generic system. Simply claiming “pediatric templates” isn’t enough.

“Second, although every specialty complains about the hit that EMRs take on their productivity, pediatricians are obviously in the worst shape. Their volume is the highest and their payment is the lowest. Just adding a minute to each encounter means an extra 30 minutes of charting a day … and I hear stories, daily, of practices adding another 1 to 2 hours! Pediatricians can’t afford to see 5-percent fewer patients. Radiologists can. And pediatricians really like to eat dinner with their families.

“One second-tier issue is that less than 50 percent of all pediatric practices don’t qualify for ARRA and the regional extension centers (RECs), as a rule, don’t understand the Medicaid rules well.  Thus, we have clients and potential clients calling us to ask how they can get money they’ll never get, or to tell us some crazy thing a REC person told them.”

Are there different sets of challenges for those that are private practices versus those that are hospital/healthcare system affiliated?
“Unquestionably – the big one being that hospital/health system pediatricians simply won’t have a choice or even a voice in the process. Yes, I’ve worked with some who appear to be at the table, but in the end … you get what they hand you. Right now, Epic is pushing everyone out but that pendulum will swing back.

Also, those employed physicians don’t have to consider the impact on their productivity in the same way. I’ve met too many peds offices whose docs didn’t take home checks for a few months after implementation – that’s not right.”

Why do you think practices like Sandhills “get it” in terms of moving forward with HIT implementations, and just being forward thinkers in general?
“If I could answer that question, I’d only be working with those practices! Every successful practice I know is successful in a different way for different reasons, but there is one common trait I see in many of them: They run their practices like the businesses they are. Keep the docs in the exam rooms, where they can generate revenue, and hire professionals to actually run the business. Just because it says “MD” after your name doesn’t mean you’re the best-qualified person to run your office. Would Dirk Nowitski or Lebron James make good coaches? I doubt it.

“In the case of Sandhills, they have some excellent, excellent staff who bring some non-healthcare experience to the table. Although I’ve seen it fail, having some management that comes from outside the healthcare system to ask and answer some tough questions pays off for a lot of practices.

“We’ve enjoyed working with them.  I should also add that they, like the other ‘heads up’ clients I know, realize that we’re on the same team. That helps tremendously.”

How long have you offered the PCC EMR? What sort of up tick in implementations have you seen since ARRA/HITECH came about?
“Our PM has had pediatric clinical features (immunization tracking, registry interfaces, well visit recall, etc.) for almost 30 years, but the official EMR itself was released about 2 years ago.

“When ARRA was first announced, we received a lot of calls, all along the lines of, “Where do I get my free money?”  It was very frustrating to explain that it would be state dependent (about a quarter of them still can’t get it) and half of our clients will never qualify due to the Medicaid requirements.

“Things are starting to settle down and get organized.  Still, we are busier right now than we have ever been. We are telling potential clients they might get installed in May or June. A nice problem to have, but it’s not fun to get some excited only to explain it will be 6 months, especially when it used to be 6 weeks!”

Are any of your pediatric clients thinking of becoming involved in ACOs?
“Thinking?  Yes.  They’re all being told how if they don’t get big, they’ll be out of business, which is utter BS. The rules, as we know them now, seem to make no sense whatsoever for pediatricians. I did see a compelling presentation by Colleen Kraft at the AAP NCE last week that very much supported the ACO-esque model she employs, but I think her situation is both unique and not potentially an ACO.

“With some issues – 5010, PCMH, etc. – we take a pro-active stance. With ACOs, I’m glad to let someone else jump first.”

How will your solutions enable your customers to integrate with ACOs or coordinated care programs?
“Far too soon to tell.  In general, I can say, “Hey, we have had really good reports that have tracked patient populations for years.”  Our clients use them all the time, as it’s both good medicine and good business.  As a practical tool, I’d put our patient recall program up against anyone’s – your front desk can crank out a list of kids who need flu shots or asthma followups in seconds – but we don’t know quite what the ACOs will need.

“One thing we’ve learned, though: when a small peds office puts its data in the hands of a large entity, it’s worth double-checking the results. For more than 20 years, I’ve helped our clients fight insurance companies (which an ACO emulates) and the insurance companies never have the data right. Ever. So if a private peds office can work with us and still be in an ACO, they’ll be able to confirm the accounting.

“Here’s my prediction: As ACOs grow, the practices who participate are going to regret losing control of their data. I’m really going out on a limb there, I know.

What do you think is the greatest challenge being faced by pediatrics when it comes to keeping up with healthcare IT?
“Not getting run over by the Juggernaut.  Everyone else’s demands are put ahead of the pediatricians and the peds usually get served what everyone else is eating.  And it rarely suits them.

“I also tell them all the time: ignore the Meaningful Use money. Completely. And ignore the “deal” that you can get from your local hospital/IPA/etc. Pick the EHR that suits you the most and go with that. All the discounts or federal checks in the world won’t make up for even a 5-percent hit in your productivity or having to spend an extra 10-20 hours a month on charting or IT work. If you do like the local deal, great!  But don’t feel like you have to leap in.”

So there you have it folks. I’d be interested to hear from a pediatrician or two who has gone through or is going through some sort of HIT implementation as a follow-up to these views. Feel free to get in touch with me via the comments section below.

All of the product literature I collected at the recent AHIMA show in Salt Lake City finally arrived in the mail the other day. As I sat sifting through all the pamphlets, brochures, case studies and white papers trying to remember why I had picked them up in the first place, one tag line in particular caught my eye: “Has your transcription seen more continents than you?”

Yes, there were plenty of technologies and services on hand relating to electronic medical records (EMRs) and electronic health records (EHR), depending on which term is your flavor of the week. But what really got my attention was the number of booths I went to that boasted transcription and coding services based right here in the good ole’ US of A, and their competitors that still internationally outsource these types of services.

Most booth reps I spoke with proudly told me that their services were located in the US. On the flip side, one company boasted that all of its services have been totally off-shored in order to meet customer demand for more competitive pricing. So what’s a provider to do?

I am, admittedly, new to the world of coding, and as this was my first AHIMA show, I was unaware of the schism that has developed in the world of domestic and international coding services. But, as a consumer that has been assisted – both competently and disastrously – by call center reps that I’m 99-percent sure were not located in the United States (despite their insistence on being located somewhere “in the Midwest”), I am aware of the consumer backlash that can result from a business’s decision to outsource its customer services.

I can only imagine, however, the pressures providers must feel when they are making decisions along these lines. Do they adhere to what their bottom line indicates is the best choice, which I assume means going international? Or do they stick with US-based companies to ensure that native English-speakers are picking up all the right nuances in documentation?

The brochure featuring the eye-catching tag line above continued its strong messaging with: “You’ve probably heard horror stories about what can happen when transcription services send work overseas. With language barriers, training deficiencies and rapidly changing regulations, mistakes – serious mistakes – are inevitable.”

Really? Inevitable is a pretty strong word. Is it a legitimate one to use in this circumstance?

A white paper from webmedx (now a part of Nuance), “Finance Leaders Rethink Transcription: Six Critical Criteria in a Changing Landscape,” provides a bit more insight into the issue: “Perhaps it was the black market sale of patient information in India …. Perhaps it was the worldwide economic meltdown and loss of U.S. jobs in 2009. Or maybe it is the pressure of tighter HIPAA regulations under ARRA’s HITECH Act. Whatever the cause, the effect is clear. Healthcare providers who sent medical transcription offshore in the past are bringing it back home.”

Are there any providers in the audience who’d care to speak to either side – why they chose to go domestic, or feel that the quality of transcription is just as good abroad? Has “cheap” become overrated?

Chime in with your comments below in answer to my question above.

My day job as Social Marketing Director for Billian’s HealthDATA and Porter Research took me last week to the exhibit halls of the Healthcare Financial Management Association (HFMA) 2011 ANI Healthcare Finance Conference in Orlando. It was my first trip to the annual show, and to its venue, the Gaylord Palms Resort and Convention Center.

Unlike my previous tradeshow experience in Orlando, at the fun yet overwhelming HIMSS, I found the HFMA event to be extremely manageable in terms of schedule, show-floor size and booth scale. Almost everyone I ran into – whether it was at our booth, at someone else’s booth, at lunch or on the shuttle – was very approachable and seemed happy to take a few minutes out of their day to speak with me, even though, as a fellow exhibitor, I wasn’t exactly their target prospect. Perhaps it was my blue exhibitor ribbon that brought out the few bad apples in the bunch – those sales reps that either refused to get off the phone when they saw me approach or those that refused to crack a smile. My only other complaint was that exhibitors were denied entry to the majority of the educational sessions.

The Blues Brothers made an appearance at the HFMA 2011 ANI Healthcare Finance Conference.

As it was my first time being in the thick of the healthcare finance world, I took the opportunity to chat with as many show-floor folks as I could. I learned a lot about how integral healthcare finance and information technology are to each other, and to bringing the overall costs of providing healthcare services down, so that providers can – hopefully – extend these savings on to the patient in the form of more accessible and coordinated care, and better clinical outcomes.

I kept my eyes and ears open for solutions relating to electronic medical/health records, and came across quite a few that piqued my interest. I found I have a soft spot for anything related to patient portals and mobile solutions. Here, in no particular order, are a few snippets of what those exhibiting companies had to offer:

Healthcare Management Systems Inc. (HMS)
- offers ambulatory EHR and practice management services
“HMS is uniquely positioned to provide community hospitals with an EHR in a much shorter timeframe. With ONC-ATCB certification for inpatient EHR, EDIS and Ambulatory EHR, HMS will ensure that you meet the health IT standards mandated by ARRA and reap the financial benefits that follow.”

I’d be lying if I didn’t disclose that half the reason I went to their booth was to grab one of their very cool, green water bottles.

Origin Healthcare Solutions
- offers integrated practice management software and EHR solutions
“Streamlines office redundancies and makes users more efficient.”

Walking into their booth made me realize why exhibitors spend a bit more for that cushy carpet – and I was in flats, mind you.

Patient Point
- offers a technology platform that aggregates and integrates in real-time with health plan data, pharmacy benefit management data, practice management and EMR systems
“Our patient-facing portal and mobile apps enable patients to securely communicate with their care team and report progress of their ongoing conditions. Patients have the choice to opt in for secure messaging via email, phone or text messaging, which enables us to close the loop effectively on patient compliance and care coordination.”

As a social media enthusiast, I wonder if patient portal solutions like these will one day find a way to securely (and privately) integrate with Facebook or Twitter. Heck, even location-based social networks like Foursquare could be used. I’m sure us patients could be incentivized to “check in” early to our appointment.

The White Stone Group
- offers the Trace Communication System
“The only system of its kind that captures any healthcare exchange – voice, fax, or electronic – for fast processing and easy retrieval.”

Based on the Trace literature and its graphics, I kept looking for the phrase EMR to pop up, but it was nowhere to be found. It seems like it could fall into this category, especially as “All communication records are consolidated in one central location for quick and easy retrieval.” If anyone knows different, please enlighten me. The fact that they cite Children’s Healthcare of Atlanta, which is right in my backyard, as a case study also piqued my interest. The study relates that “Trace was used to overturn $2 million in denials and prevent an estimated $4 million in denials. Productivity improvements saved 107 staff hours per month and allowed for reallocation of five FTEs.”

* Editor’s Note: Erin McCarty, Director of Marketing at The White Stone Group, Inc., was kind enough to clarify the Trace system’s relationship to the EMR: “Trace is a platform that captures communication (voice, fax & electronic), indexes the records by patient and stores them for web-based retrieval. It is primarily used to capture revenue cycle communication that occurs with payers, patients and physicians. Trace does not replace the EMR, which is documenting the patient’s clinical data. Rather, it complements the EMR by capturing communication that helps hospitals receive accurate reimbursement for care provided. Common uses include recording authorization calls to payers, out-of-pocket discussions with patients, capturing faxed physician orders, visits to payer web sites, etc.”

Healthland
- offers a certified EHR to rural hospitals
“In addition to our ONC-ATCB 2011/2012 certified EHR software, we also offer clients comprehensive services, support, training and financing to help them receive incentive dollars, and ultimately, provide the high-quality patient care their communities expect.”

I also noticed in their brochure that they offer a white paper on “10 Must-Haves to a Successful EHR Implementation.”

Phreesia
- offers an electronic patient check-in solution
“With patient payments making up $1 out of every $4 of medical practice revenue, it’s no wonder 10,000 clinicians use Phreesia as their electronic patient check-in solution.”

Patient portals and electronic check-ins were popular at the show. Phreesia’s solution stood out to me for its bright orange color. While not directly tied to EMRs, I wonder if these sorts of technologies will become interoperable with them, especially as doctors and payers begin to work more closely together in the name of more coordinated care.”

Athenahealth
- offers integrated physician billing, practice management and EHR services

Their white paper on “The HITECH Act and Your Practice: Eight Tips for Successful EHR Adoption” caught my eye. It got me wondering how they were able to whittle it down from Healthland’s 10.

A number of other companies were on hand with EHR solutions, including:
MedQuist
Healthcare Anytime
Sandlot Solutions
PatientWorks

I’ve been having a number of discussions online and through email with people about the future of the EHR incentive money. A number of people are quite concerned with the government funding for the EHR incentive money. You may remember that I posted about this before on multiple occasions and had some really interesting discussion.

Here’s a summary of some of the points that I’ve heard people making when it comes to the EHR incentive money being taken away:

1-There is a crucial difference between the two steps required for Congressional funding, a-authorization and b-appropriations. Congress can authorize, but cannot appropriate for 5 yrs. This applies to the EHR stimulus money. Thus the 5 year EHR payment has been authorized, but no EHR funds have been, nor can they be, appropriated for 5 years, right?

2-There is $18k this year for doctor Medicare EHR. But not the remaining $26k over 5 years has not been apropriated (same applies to hospitals funds).

3-The budget deficit and debt ceiling suggest Congress will be looking now and in the future for cutting every dime they can,
and thus the $20B or so for EHR could be part of the cut. Thus there may be reduced EHR funds, or none, appropriated by Congress after this year.

I still believe in my gut that the EHR incentive money is going to be safe and still around going forward. There’s little benefit to cutting a mere $20 billion from a program that is generally bi-partisan. Plus, no one in congress really knows the potential good or bad impacts of the HITECH act on EHR and healthcare IT. However, it’s really easy for them to quickly assume that more technology in healthcare is good and worth funding (whether the way they’re doing it is good or not…a subject for a different post).

It’s certainly not beyond the realm of possibilities that the government could make some sweeping cuts and the EHR incentive money is a casualty of those sweeping no holds bars type cuts. Point being that I don’t think there are any people in congress that are passionately for it or passionately against it. So, I think that means that it will likely either get carried forward on a whim or cast aside on a whim.

How’s that for a concrete answer? Are there points that I’m missing? Are we misunderstanding the HITECH funding process? Feel free to chime in with any knowledge you might have of the government process.

Does the title of this post make anyone else cringe? It sounds like government at its best (or worst depending on how you want to look at it) to me. I remember when I once heard the famous investor, Carl Icahn, talk about he could go into any company slash the staffing and maintain the same productivity. His point being that so many larger companies have a lot of people who don’t produce much value. Government is very similar in people and rules and regulations. However, they don’t get someone like Icahn who comes in and cuts out those that aren’t producing.

You’d think with this analysis that I’d then be excited about the massive Review of Rules and Regulations that HHS is undertaking as reported on in this article by Health Leaders Media. I do think that it’s good to do reviews and trim down regulations. My problem is that I’ve rarely seen someone in government do a review which ended up with stuff chopped out.

I’m not completely blaming HHS and the people that work there. The ones that I’ve met personally have been incredibly bright and thoughtful individuals. They hate all the red tap as much as the rest of us. The problem is that in many ways they’re tied in what they can actually do. Part of it is politics. Part of it is legislative requirements that are handed down to them.

I think the best indication that this massive review of rules and regulations isn’t going to yield the tens of millions of hours and billions of dollars in costs savings is the 89-page “Preliminary Plan for Retrospective Review” (PDF) that was released by HHS. A mere 89 page document to propose the preliminary plan for review (that’s sarcasm for those that missed it). I can’t help but wonder how many pages of additional documentation will be produced from this review. Maybe we should ask that they eliminate 1 page of regulation for every page of review that they produce. Then, we might yield some interesting results.

I know I’ve been gaining a much larger understanding of the regulation and rule making process thanks to the HITECH act. Considering the large effort that many people have put into that process, it makes me wonder what types of results a review of the HITECH regulations and rules would actually produce. Needless to say I’m skeptical of the benefits.

Reminds me of what my friend who works for the US government told me: “Am I doing something that’s important and valuable? Absolutely! Could it be done for about half the cost? Definitely.” Too bad we don’t have Icahn like take over of government that could easily cut out the waste in government.

My post on lousy EMR interfaces continues to stir reactions among EMRandEHR readers.  Those responses include the following, from reader Bret Shull:

Thank you for bringing up yet another important matter in the never-ending drama that is EMR.  Until a merger in Dec. 2009, I owned and served as administrator for a  4 physician diagnostic clinic in southern California.  While marketing our professional and clinical services over the years, I consulted with hundreds of practices and physicians regarding various practice management issues.  Based upon my inquiries, the vast majority of the providers who have deployed  EMR revert back to paper SOAP notes within a few months.

When asked why they go back to paper, they confess that they find EMR’s very rigid; the logic forces them into a completely unfamiliar (and often inferior) approach to their patient encounter. Subsequently, the physicians either stay after hours to type and click their notes into the EMR or delegate the arduous task to a staff member.  The comments I’ve heard from my referring physicians follow along these lines:

• “I’ve been practicing medicine for 20 years… What do the people who designed this software know about practicing medicine that I don’t?”
• “Why can’t an EMR learn how I practice instead of forcing me to assess my patient its way?”
• “It seems the more we customize the templates, the more pull-down screens we create, making the system even more cumbersome.”

Even with the HITECH incentives in place, many physicians are still hesitant to “take the plunge”.  At the risk of stating the obvious, I personally believe the cumulative effects of these negative experiences throughout the market have served to stifle EMR adoption.

As it turns out, Shull did find a platform he liked eventually. He’s a big fan of the Praxis EMR, which he says works far more intuitively than the other systems he tried.

I can’t vouch for Praxis — or any EMR for that matter — but it’s great to hear that Shull’s was happy with what he found.  Has anyone else found a system they believe doctors will actually  use?

As anyone reading this blog knows, there’s not enough HIT specialists available to  manage  the massive wave of EMR implementations under way.  In fact, many CIOs fear that they won’t be able to find enough EMR help to get stimulus funding, according to a CHIME survey from late last year.

More than 70 percent CIOs responding to the survey said that they might not be able to bring enough staff on board to get HITECH incentives, CHIME reports.  Many are turning to third-party consultants to get the job done, but as we all know, outsourcing the implementation of a mission-critical system like an EMR comes with problems of its own.

So, wouldn’t it be nice if there was a way to reduce the need for scarce health IT veterans and fob off at least some of the work on paraprofessionals?  It seems that at least one organization has exactly that in mind.

A group of impressive HIT experts, led by Steven Lazarus of the Boundary Information Group, have come together to offer a series of certification courses which train students to handle some EMR management functions.   The certifications include:

*  Certified Professional in Electronic Health Records (CPEHR)

*  Certified Professional in Health Information Technology (CPHIT)

* Certified Professional in Health Information Exchange (CPHIE)

The organization, known simply as Health IT Certification, has already partnered with three Regional Extension Centers. It’s also working with several trade organizations, including the MGMA and WEDI.

The group frankly acknowledges that these certifications are no substitute for in-depth health IT expertise, but argues that people who meet its certification requirements can be a big help nonetheless.

My guess is that such paraprofessionals would be especially attractive to small medical practices, which seldom — if ever — have a traditional IT expert on staff and can ill-afford high-end EMR consulting.

However, I don’t know if they’d make a dent in a hospital or health system’s staffing problems, as I doubt that even the best-informed paraprofessional could handle the implementation of high-end enterprise EMR systems.

That being said, it’s hard to tell what will and won’t work as the EMR juggernaut descends upon the industry.  Maybe these certified folks — call them HIT extenders? — can make a real impact.  What do you think?

I love the title of this post since it uses the word change. People when they see change start to get really concerned. For some reason we don’t generally like change. We often like it after the fact, but rarely want to engage in change. I’ll be the first to tell you that implementing an EMR requires change. Anyone who tells you otherwise probably has something to sell you. Certainly some EMR require more change than others, but they all require a change.

The American Medical News put out an interesting article discussing what they said would be 5 ways meaningful use will change your practice. Here’s their 5 ways and my commentary on each of the items:

Patients will be more involved in their care – Certainly meaningful use has some requirements that encourage the sharing of clinical information with the patient. I expect in future meaningful use stages we’ll see even more sharing of the clinical information with the patient. However, I don’t really see this sharing as translating to a more involved patient. Tons of people miss incorrect charges on their bank account and credit card statements and they have all that information. I’m sure the same will happen as patients get access to this information. Many won’t care to look and many of those that do look won’t have much of an idea what they’re looking at.

With this said, there is a general movement to the active and involved patient. Combine the easy access to health information (good and bad information I might add), the easy social interactions amongst patients (ie. asking your friends on Facebook), and other changes we see in society and the patients will be more involved going forward. I just don’t see meaningful use being a huge driver for this.

Doctors will find it easier to see how they’re doing – Ummm…this seems way off base to me. First, because it’s pretty hard to define “how they’re doing.” So, it makes it hard to talk about. Let’s just focus on the meaningful use measures. Does anyone really think that tracking the meaningful use measures is going to make a doctor better at what they’re doing? Can they really be used to measure how well a doctor is doing? I guess I just don’t think meaningful use is the right “report card” for doctors.

Physicians will collaborate more with other doctors – Stage 1 definitely does little to help this happen more efficiently. We’ll see if stage 2 or 3 takes it much farther. Although, if stage 3 takes it too far, I imagine many will opt out of showing meaningful use for stage 3 since the payouts are so small at the end of the EHR incentive money.

Long term, having an EMR will facilitate collaboration and information sharing amongst doctors. However, we don’t have the highways for that information built yet.

Physicians will pinpoint practice inefficiencies – This feels a little like the second one to me. However, it’s worth also pointing out that I think it would be a very difficult argument to make that meaningful use somehow makes a practice more efficient. I could certainly make an argument (which I’m sure many would love to argue against) that an EMR can make a clinic more efficient, but not meaningful use.

Physicians will need a firmer grip on data security – MU stage 1 has little HIPAA requirements and I don’t expect MU stage 2 and 3 to change that. There are some privacy and security requirements in the EHR certification that try and take data security and privacy in an EMR to the next level. Also, the HITECH act has provided some “teeth” to the enforcement of HIPAA which it never had before. I still think we need a few more clinics to get “bitten” by it to really understand what the requirements are going to be and how they’re going to enforce it.

Spent countless hours worrying over meeting Meaningful Use standards?  Dr. HITECH feels your pain. HITECH, otherwise known as Germantown, MD-based Dr. Ross Martin, MD, MHA, has produced an educational video which offers you the highlights — and we’re serious about this — of Stage 1 Meaningful Use requirements.

As you’ll see, however, Dr. Martin isn’t a conventional lecturer. As Dean of The American College of Informatimuscology, he keeps it real with a hip-hop tune dubbed “The Meaningful Yoose Rap.” (By the way, you’re interested in becoming a fellow of the college, Dr. HITECH invites you to submit musical samples.)

Check out the video and tell us what you think.  Personally, I think a little humor never hurts, even when it comes to a serious topic like MU. But hey, some people just don’t know how to have fun…

John’s Note: Much of this post will be child’s play for those of you reading the blog that are steeped in meaningful use, the HITECH act, EHR Certification, and the EHR stimulus money. However, I thought this guest post was a nice intro to the EHR stimulus money for a doctor or practice manager which was starting to learn. I’m all about helping doctors, so here it is.

90 days of data collection. This is what is required for year one meaningful use. This means by October 1 you better be collecting data…and hopefully you didn’t just start on October 1…that would be playing with fire.

What really is the purpose of Meaningful Use? In the grand scheme of things, the CMS wants to make sure that a practice hasn’t bundled together a spreadsheet and word processor, call it an EHR, and then try to claim a big reimbursement. So, sure, it makes sense that the CMS would have some requirements for your EHR.

As is the situation anytime you try and get money from the government, the list of requirements is lengthy, the red tape is plentiful and the maze continues to get more complex.

So is the case when “proving” meaningful use. Hopefully you aren’t of the idea that buying a Meaningful Use certified EHR makes you a Meaningful User.

Having an EHR with that “certification” stamped on the box is not like an Easy Button.

Selecting that EHR is the first big hurdle you have to conquer…now you have to show you are a Meaningful User.

The items of proof are shown here in this CMS summary [PDF]. What you’ll see is there are 15 Core Objectives you must be able to report on.

That shiny new EHR should have all of these reports built right in. You better try pulling some of those reports to make sure there is some data in them.

So, those 15 mandatory Core Objectives are already selected for you. Next, there are five more you must select from a gallery of ten.

Which objectives should you choose? Wait for it…IT DEPENDS.

Such the non-answer answer.

It does depend on a number of items, but really which five would you choose?

The easiest to gather? DING DING!

Why not?

Why make this craziness any more difficult than it needs to be.

We’ll go over the Menu Set Objectives, and which ones are the easiest for you to pull, in a future article.

John Brewer is the founder of HIPAAaudit.com. He and his team help physicians run HIPAA Compliant practices in the simplest, most pain free way.