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$75 Million Paid in Medicare EHR Incentive Money (Requires Meaningful Use)

Posted on May 31, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com 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 InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Interesting to hear the $75 million number. Certainly it’s still early in the year, so it will be interesting to see these same numbers after the first year of the EHR incentive money. Plus, it’s important to note that this $75 million required the hospitals and medical practices to show meaningful use.

A few excerpts from the article that’s linked above:

CMS officially released on Thursday information about the more than 300 hospitals and physicians that received the incentive payments. Award amounts were not included. The list includes:

Beth Israel Deaconess Medical Center (Boston, Mass.)
Bender Medical Group (Ft. Collins, Colo.)
El Paso Heart Center (El Paso, Texas)
Hewitt Medical Group (Bakersfield, Calif.)
Northshore University Health System (Evanston, Ill.)
Regents of the University of California (Sacramento, Calif.)
Wellmont Cardiology Services (Kingsport, Tenn.)

300 hospitals and Physicians. How many doctors does that still leave? Well, let’s just say that 300 gets rounded to 100% I think. I’d also guess if you took all of the payments made to physicians, it would be a very small percentage of the 75%. I’ll have to dig into this a bit more.

Including the $83.3 million in incentive paid for the Medicaid EHR program, CMS has now distributed $158.3 million in incentives.

$158.3 million. They’re working their way to the $36 billion. It’s still early in the year.

The Effect of Dropping an iPad

Posted on I Written By

John Lynn is the Founder of the HealthcareScene.com 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 InfluentialNetworks.com and Physia.com. 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 is a little off topic, but not really since the iPad craze in healthcare is so big. Because of this fact, I was quite interested in this video I found which tests out what would happen if an iPad was dropped. They actually drop 2 iPads. One with a smart case and one without a case. They start off first dropping it from waist level and then shoulder level.

Yes, this is a little hard to watch a2 perfectly good iPads get destroyed, but it is interesting to see what might happen if a doctor were to drop their iPad on their rounds.

Yes, it is worth noting that it’s unlikely that the iPad would drop straight on its face like in this video. It’s also worth saying that there are even more durable cases available for those that are concerned about iPad’s being dropped. Although, I have to admit that I’m amazed that the Smart Case did as well as it did after being dropped.

Crazy EMR functions as selling points

Posted on I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

When are you asking for too much nonsense in an EMR system?  Are you being fed a load of jellybeans by an EMR vendor about what theirs can do?

An Ob/Gyn’s practice manager recently called to speak with Ken, my practice manager, about functions of our EMR, Practice Fusion.  She had a rather specific question during the conversation that sparked scratches of heads and raisings of eyebrows in our office. “But will your EMR system allow searches of office notes by keywords?” she asked.  She said she wanted to have this function in order to quickly look up an old office note in which she might remember having a conversation with a patient about something specific and need to quickly find it. That seemed cool and interesting, especially since some email systems, including Gmail, allow one to do this easily.

However, there was also something weird about this question. I have only very rarely thought to myself, “Now which patient did I see that I spoke to about something specific?”  I did this a month ago when I remembered a patient who was an IT consultant being treated for Grave’s disease.  I was able to find his note in about a minute by searching my EMR system for patients I had seen recently with an ICD-9 diagnosis code for Grave disease.  Practice Fusion lets you do this easily.

But who put this in her mind as an essential feature for an EMR system? Was it perhaps an EMR vendor? Did they tell her, “Well this is an excellent function that our system can do that many other systems can’t. Be sure to ask other vendors if their systems can do this.” Maybe I am wrong and this is not how this strange desire of hers ended up coming into being, maybe she just wanted it all on her own, but Ken and I wondered if a vendor wasn’t involved.

My opinion of such a function is that it seems pretty superfluous unless you have a specific need for it that occurs all the time. My little anecdote about the IT consultant that I ended up searching for by other means only happens very rarely in my practice. And so my long-winded recommendation for this post would be don’t get sold on systems based on gimmicks. Think about what you really need rather than the vendor wants you to sell you on.

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.

Using PIMSY EMR on an iPad and Android Device

Posted on May 30, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com 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 InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

One of the regular EMR and EHR readers, Judy, recently took up the challenge I posed in my previous post about Every EMR Vendor available on the iPad. She downloaded the LogMeIn Ignition app that I mentioned in that post and tried out her PIMSY EMR software on it. Thanks to Judy for sharing her experience.

The following is her experience and review.

I tested the new LogMeIn app to see if I could access PIMSY EMR from my older Droid and from an iPad. It takes a little getting used to: you have to familiarize yourself with how to navigate on the screen and how to change the size to get the screen view that works for you. Once you get that done you are good to go. That said, there are 2 ways to change the size: a magnifying option at the bottom of the screen or a zoom in bar on the right hand side; you can enlarge as much as needed. There are also 2 options for moving around: you can move the screen with your finger (the cursor stays put) or you can move the cursor like a regular mouse; I prefer navigating around the cursor. Both options make it simple to maneuver.

If you’re used to texting and typing on a smaller keyboard, it will be easier to adjust. The app itself gives you a keyboard that takes up approximately half the size of the screen, so larger phone screens like Droid 2 or iPhone would have a bigger keyboard than a regular Droid, and the iPhone keyboard was comparable to a regular size. For those who aren’t used to navigating and typing on a phone screen, there will be an adjustment period. If you’re connected to dual monitors, you can easily switch to either one, and I was able to watch a video.

The speed is slightly slower from phone or iPad to computer but very good from computer to computer. The app is not offered on a Blackberry. I would highly recommend this app to anyone who wants to connect to their desktop remotely; it worked great to get into PIMSY. Well worth $29.99.

Proving EMR ROI IS Still Tough, So Buying Takes A Leap Of Faith

Posted on May 29, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Folks, if you’ve worked or presently live in the enterprise software world, you know that proving that you system generates a worthwhile return on investment is tricky.  Sure, vendors sales staffs usually offer some neat calculators that prove you’ll see 1000% return by next Tuesday, but internally, even they admit that making such estimates is more black magic than science.

While some of you may have different experiences, it seems to me that proving that an EMR can generate a return on investment reasonably soon is particularly difficult. Sure, most hospitals and medical practices know their annual revenue run rate, and have a good breakdown of their expenses in hand, but are they set up to detect the effects going electronic can have?

After all, while some enterprise software directly helps companies generate revenue — most obviously, lead-generation monsters like Salesforce.com — others earn their keep but preventing problems from happening or improving quality. And if a provider organization doesn’t know what their mistakes are costing them, and doesn’t pay a direct price when patients fare poorly, how can they pin down how much financial benefit their EMR produces?

 

Admittedly, as the quality data reporting bandwagon continues to roll faster, everyone from small practices to giant hospital systems are likely to have a better idea of where they’re slipping — they can’t afford not to, as they’re likely to forfeit incentives paid by Medicare or private insurers.  And most cases, it will take an EMR to organize, analyze and report out that data effectively.

Unfortunately, providers can’t expect huge bonuses just for buying an EMR. (OK, let’s be honest and admit that HITECH dollars are nice to have but not enough to make  or break a viable business.) So they’re having to make a leap of faith and invest in a system, sometimes a very expensive one, on the still-unproven assumption that it will offer tangible financial and organizational benefits in the near future. That’s gotta hurt.

Aggressive providers have been taking this risk for years now, and many have been very glad they did.  Not only have there been some nice examples of how hospitals and health systems have benefitted by their EMR investment, I’ve met doctors in small practices who absolutely rave about how productive their shift to EMRs has been. So there’s at least anecdotal evidence to support EMR buy-in.

Still, it sure would be nice if there was a one-size-fits-all ROI we could offer providers, or even a decent series of estimates. Right now, many are just going to have to fly blind.

How will Healthcare IT and EMR save on Medicare costs? – EMR Video Series

Posted on May 28, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com 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 InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Ok, so this was the first video that I made in the EMR video series (see the other video I posted on EMR data sharing). So, I stumble around a little bit on the video, but I think I provide some interesting answers to the question. Although, I’ll admit that it’s a really hard question to answer.

Here’s the question I try to answer in this video:
How will Healthcare IT and EMR save on Medicare costs?

Let me know if you like these videos. Also, let me know what I might have missed in this video.

AMA’s Health IT Portal: Will Doctors Bite?

Posted on May 27, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Last month, the AMA announced that it was launching a health IT portal for doctors.  The AMAGINE platform includes a fairly robust range of products, including three EMRs, and its price range seems pretty reasonable. Still, I’m somewhat skeptical it will be popular. Lest I be accused of being arbitrary, let me explain.

On the surface, the idea or and product line sound great. In addition to the EMRs, the lineup includes e-prescribing, claims management and clinical support systems as well as reference tools. Vendors involved include Allscripts, CareTracker, Quest Care360, NextGen and DocSite.

Subscriptions to the surface range from $20 per month for e-prescribing to $300 per month for the EMR options, numbers that aren’t likely to send most practices into shock.

Not only that, the AMA seems to have preliminary evidence that this approach works. The trade group pilot-tested the AMAGINE on Michigan doctors for about two years prior to going national, and has to assume that the physician association would have pulled the plug if the pilot went badly.

All that being said, I’m still pretty skeptical that the approach will work, for reasons including the following:

* Despite its being the best-known and largest physician group in the U.S., the AMA doesn’t have a great reputation with up-and-coming young physicians who are first to adopt health IT

* It may sound counterintuitive, but I don’t think doctors want the AMA or anyone else to narrow down their EMR choices. Given the stakes involved, my sense is that physicians want to do a lot of exploring before they commit their lives and workflow to a new system.

* While a best-of-breed portal approach may actually be a good idea, I have a gut feeling that it might actually overwhelm or confuse some physicians. (If it were me, I’d be thinking “One decision at a time please!”)

* Say what you like about vendor technical support, but I bet any decent player would offer better technical support, education and training than an AMA venture.

So, what do you think? Am I off base here, or is AMAGINE going to face an uphill battle?

 

 

Diabetes Practice Options EMR interview!

Posted on I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

About a month ago, I had the wonderful opportunity to be interviewed by Deborah Neveleff for Diabetes Practice Options.  This interview focused on using electronic medical records to enhance diabetes care.  My part starts at the end of page 3 and runs to the bottom of page 5.  Have a wonderful Memorial Day weekend everyone!

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.

 

EHR Question and Answer Video: EMR Data Sharing

Posted on May 26, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com 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 InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Yesterday I started testing out a new idea where I’d film some original EMR and EHR videos where I answer questions about healthcare IT and EMR that people have sent to me. I’ll post the first video here and possibly another one this weekend. Then, I’ll probably start posting the videos on my new EMR and EHR video website. Although, I may do some updates with links to the latest videos that are posted.

It’s a low budget production as you can imagine. I also was streaming it live on the internet, so you’ll see me look down a number of times to check how many were viewing it live. Those things aside, hopefully you’ll find the content of the video interesting and useful.

This first video tries to answer the question:
Does the EMR allow data sharing with the patient’s PHR and/or Social Net account(s)?

As always, I’m interested to hear your thoughts on the subject as well. Was there anything I missed? Was I wrong about anything? What else is important about EMR data sharing? Should we be able to share our EMR data with social networks like Facebook, Twitter, etc?

Also, if you have other questions you’d like me to answer in a future video, be sure to leave a comment or let me know on the contact us page.

CMS doesn’t get it? Can they ever?

Posted on I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

Katherine Rourke gets another gold star from me for her May 16 post, “Health IT Expenses Burden ACO Startups, But CMS Doesn’t Get It”.  I have this funny suspicion that there are a lot of things that CMS doesn’t get, and most of them involve marrying efficiency with smartly constructed programs.  As a provider who has decided to opt out of Medicare, part of what led me to make this decision were the inefficiencies involved in trying to work with a government-run program whose priorities do not include customer service.

A case in point is the new drug Prolia, used for treating osteoporosis and preventing potentially life-threatening fractures.  Yesterday, I found out that Medicare — unlike commercial insurance companies — does not authorize the use of specialty pharmacies, which can ship the drug to doctors and directly bill Medicare themselves.  Thus, I am forced to shell out around $850 for a single dose to be sent to me to give to the patient.  I then bill Medicare and hope all goes well and there are no delays with reimbursement.  Needless to say, I would be hard pressed to offer this therapy in the future to Medicare patients if I were continuing with it.

And what’s with calling an HMO established by CMS an ACO?  Is this just a clever ruse to diguise exactly what an HMO does?: keeps costs down by paying less and causing the patient to, thus, get less?  My old 8th grade high school teacher Ms. Rainey, bless her soul, used to have the most apt quips when we would come to her class every day.  And she was so right, again and again.  One morning, she told us the story of her son who bought a pair of sneakers at Payless Shoe Source.  In about two weeks, they were falling apart.  Her comment?   “Pay less, get less.”

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.