Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and EHR for FREE!

States Lagging Behind in Medicaid Meaningful Use Payments

Posted on March 30, 2012 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 FierceHealthcare.com 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.

If I were part of CMS, I’d be pretty annoyed right now: Apparently, state Medicaid programs are beginning to be a wet blanket in the race to get providers up to Meaningful Use standards.  According to InformationWeek, a dozen states aren’t yet paying out Medicaid incentives, and some of those haven’t even launched incentive programs yet.  Not good news, to say the least.

According to a new post on CMS’s official blog, CMS has handed out Medicare and Medicaid incentives to more than 59,000 eligible professionals and 2,000 hospitals. It also noted that the Medicaid program alone had made more than $1.8 billion in MU incentive payments between January 2011 and the end of last month.

That’s not a bad start, but the slow pace of some Medicaid MU programs is a drag on meeting CMS’s overall goal, which is to have 100,000 providers get MU payments this year.

True, some states are clearly doing their level best: Ohio, which wants to reach 40 percent of eligible providers, Washington, whose goal is 7,000 EPs and hospitals, California, which is trying to get 10,000 providers set up for Medicaid incentives by June; and New York, which hopes to get 6,000 providers get incentive payments in 2012. And 43 states in total have launched a Medicaid incentive program and begun registering applicants, the article reports.

But then there’s the naughty states, which include Hawaii, Idaho, Minnesota, Nebraska, Nevada, New Hampshire, and Virginia — which haven’t launched their Medicaid incentive programs at all. As of December, however, CMS expects (demands?) that all states be making Medicaid incentive payments by June, according to a CMS official quoted in the story.

In the grand scheme of things, I’m pretty confident that Medicare, not Medicaid incentives, are going to drive the train here.  That being said, it is worth asking whether the states’ lagging efforts will create serious problems for the MU program. As I see it, it could go either way, but regardless, it’s not a good sign.

Who do Doctors trust in EHR Selection?

Posted on March 29, 2012 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.

Anne Zieger has a really interesting post about Hospital Recommended EHR software over on Hospital EMR and EHR. In it she talks about how most doctors don’t take the hospital recommended EHR software. This will come as little surprise to doctors and likely to hospital systems as well. Doctors and hospitals have always had a mixed bag relationship. There’s this odd co-dependence that usually makes the relationship awkward.

When it comes to EHR adoption, physicians love the idea of getting IT and implementation support from the hospital. They also love the group buying power. Although, they also are concerned that they’ll just be a small fish in the big hospital waters and not get the support that they think they deserve (and maybe they do). Although, the most important reason doctors don’t want to get the hospital recommended EHR is they don’t want to create that “permanent” tie to the hospital. Of course, this is one major reason why hospitals want doctors to take their recommended EHR.

If we can say that doctors don’t trust hospitals recommended EHR software, then who do they trust?

That answer is easy: other doctors.

There’s something really powerful about the trust connection that doctors have between themselves. I’m sure there’s a number of factors that contribute to why they trust doctors more. It probably goes back to the bond that going through medical school creates. Reminds me of when my brother described how boot camp in the Marines created a unique bond between Marines. Doctors seem to experience a similar bond around medical school. Even if they’ve never met before, they can connect sharing “war stories” from their medical school and residency experience.

In many cases, their physician colleagues are a great reference pool for them when it comes to EHR selection. This is particularly true if their colleagues are in the same specialty and have a similar practice size. Although, once doctors start talking to colleagues from different specialties or different size institutions then they often run into trouble. The EHR that works for a 100 office multi-specialty clinic likely won’t be the right one for a solo practice.

IT Service Companies
I also believe many practices have a great trust in their IT service provider. You can see this trend in how many IT service company employees comment and subscribe to this site. Plus, many of them offer some sort of specialized EHR service to doctors. In fact, many are VARs for EHR vendors.

Internet EHR Info
Turns out that most doctors are very independent thinkers. So, many of them want to do the EHR selection on their own. This leads them to the internet to search and narrow down the list of EHR companies. I expect the internet resources for EHR are probably now the most influential part of a physician’s EHR selection process. Can you imagine a physician selecting an EHR without online research? I can’t.

Who else do you see influencing the EHR selection process?

Social Media Resources for Healthcare IT Job Seekers

Posted on March 28, 2012 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

In my attempts to prepare for a panel discussion during last week’s TAG Health-sponsored HIT Job Fair, I corresponded with a number of you, dear readers, on how you and your colleagues have or are currently using social media in your job hunt. Thanks to everyone who shared their experiences, tips and tricks with me. I was able to relay some of it to the eager job seekers in the audience – many of whom were only vaguely aware of the potential social media can play in helping candidates: manage their personal brand and digital footprint; educate themselves on a particular niche as they transition from one industry into another; and of course, find job openings.

McKesson and Children's Healthcare of Atlanta were just a few of the employers at TAG Health's recent job fair.

The following is a list of resources that I didn’t have time to share during the job fair. Many of them come directly from the fingertips of EMRandEHR.com readers.

* Social Networking for Career Success – great book – no matter what industry you’re in – by Miriam Salpeter of Keppie Careers. You can follow her on Twitter and learn more at her website, KeppieCareers.com, which also includes a guide to Google+ in the books section.

* NWHIT.org – a website devoted to Health IT Workforce Development in the Northwestern States, part of the Community College Consortia to Educate Health IT Professionals Program. It includes some great advice blogs by Health IT Talent Specialist Yvette Herrera-Greer, as well as a session from Matthew Youngquist of Career Horizons on using LinkedIn as an effective tool for job seekers in the Health IT sector. You can also join the organization’s group on LinkedIn – just search for NW Healthcare IT Workforce.

* the @HIMSSJobMine Twitter account is a great national resource, as is the @TAG_Health account if you’re in Georgia.

* Twitter hashtags you may want to consider paying attention to include #HealthIT, #Jobs, or the name of the company, technology or position you’re interested in, such as #CIO, #Allscripts, #Epic, #EHR, etc.

* Pinterest – yep, you read that right. I’d say it’s a little too early to tell whether it will be a valuable resource for folks in healthcare IT, but the recent Forbes article I came across on the subject is worth a look, especially if you’re already a fan of the new social media sight. (Side Note: You can Find Healthcare Scene and EHR Screenshots on Pinterest also)

* CareerEnlightenment.com – a website devoted to helping people use social media to get jobs. Blogger Joshua Waldman is also the author of Job Searching with Social Media for Dummies.

Have additional resources and tips to add? Please share yours in the comments below.

MediConnect Sold for $348 Million to Verisk Analytics (VRSK)

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.

The news was just reported that MediConnect is selling to Verisk Analytics (VRSK) for $348 million.

MediConnect Global Inc., a home-grown Utah company that provides medical records-retrieval, scanning and storage services, is about to be sold to New Jersey-based Verisk Analytics Inc. for $348.6 million.

The deal is expected to close by the end of the month.

I think we’re going to continue to see a number of companies that weren’t previously in the healthcare space entering the healthcare space through acquisition. Seems like MediConnect is a well connected company in the healthcare space. Here’s more details on MediConnect:

MediConnect has a repository of nearly 10 million medical records that are digitized, indexed and securely hosted online. It counts among its clients four of the five leading health insurers in the country.

I’ve seen a huge influx of scanning companies going after healthcare business as doctors continue to move to EHR software. Scanning the past charts is a popular option once you move to an EHR. I find it interesting that MediConnect scans and stores the charts in the cloud. I’m surprised I haven’t seen more companies doing this same service. Many scan, but then provide the records locally to the clinic instead of storing them in the cloud.

How Can I Spend Less Time in a Patient Encounter?

Posted on March 27, 2012 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.

I was reading on LinkedIn the other day, and someone suggested that in far too many ways we’re restricting our view to the following question:

How can I spend less time in a patient encounter?

While this certainly applies to our use of technology in healthcare it goes well beyond just EHR. Although, one challenge with technology like EHR is you get exactly out of it what you design it to do. If the focus of your EHR is just about minimizing the patient encounter, then that’s what you’ll get. If the focus of your EHR is to maximize reimbursement, then that’s what you’ll get. If the focus of your EHR is to meet government requirements, that’s what you’ll get.

Instead, of you focus an EHR on providing amazing patient care, that’s what you’ll get.

Many like to blame the EHR vendors for not producing EHR software that improves patient care. While I think they hold some responsibility, they are mostly just trying to satisfy the demand of their customers.

Healthcare deserves better and we need to find ways to incentivize doctors to want an EHR because it improves patient care. Otherwise, we’ll keep getting great billing engines which minimize the patient encounter at the expense of great health care.

Healthcare Mandate and Healthcare Reform Infographic

Posted on March 26, 2012 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.

The US news world is covering this week’s supreme court hearings on the constitutionality of the healthcare reform law, also known as the Accountable Care Act (ACA). No doubt the ruling of the supreme court could have a really major impact on healthcare reform in this country. As best I can tell, all things seem to be pointing at the law remaining in place, but when you’re dealing with a few people deciding something this important things can change quickly.

I’ll admit to not being an expert on the details of ACA and healthcare reform. Plus, each side is spitting out so much rhetoric that it’s hard to really get a hold of the real details of what is going to happen with this new law and what the long term impacts from it will be. Seems like rational thought and reason is going out the door as emotions and partisan lines take over.

I did see this healthcare reform infographic from AHIP hitting my Twitter stream a few times. It analyzes an important nuance of ACA and healthcare reform. If you cut out the mandate for health insurance and leave in the other ACA market reforms, then as this graphic shows the insurance premiums go up and the uninsured increases as well.

This is basic rules of health insurance really. The ACA market reforms basically add a bunch of unhealthy patients to the insurance companies patient list. That’s why insurance companies were denying them coverage in the past. It seems the hope is that the health insurance mandate would also add a group of healthy patients as well since they could help offset the cost of the expensive patients.

This doesn’t have all that much to do with EMR, but it’s an incredibly important topic in healthcare that could fundamentally change the landscape. So, I thought it worth talking about.

One thing should be made clear. The ACA is different than the ARRA/HITECH legislation. I believe there is a little bit of healthcare IT money in the ACA, but when you talk about EHR incentive money you’re really talking about ARRA/HITECH. Only ACA is going to the supreme court. ARRA/HITECH could be effected by future legislation, but is a separate and distinct bill.

Docs Gone Wild

Posted on I Written By

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

Update: Be sure to read A Davis’ comments on this post as well where he provides some more perspective and understanding on the magnitude of the issue.

And in a bit of a break from our usual EMR and EHR content, we have a couple of stories that caught my eye on Fierce Healthcare.

The first story is about a talk on provider disruptive behavior presented at the American College of Healthcare Executives (with the somewhat hilarious acronym ACHE) Annual Congress in Chicago. The kind of behavior that includes ponytail-flipping, pestering patients and colleagues for dates and not taking no for an answer, threatening to use AK47 etc. Rolling your eyes because you’ve never encountered these doctors from hell? Me too. To a person, the doctors I’ve encountered here in the US have been professional, courteous and polite.

But how common is this kind of stuff?

The Fierce article doesn’t say, but the not-so-subtly titled “Physicians behave badly online” provides some statistics on doctor behavior online.

The litany of complaints against doctors is as long online. The most common complaint is that doctors ask patients out on dates. According to the article, 48 participating state medical boards had at least one case of online misconduct, and the accusations leveled include:

Inappropriate online communication with patients (69 percent), such as sexual misconduct

Inappropriate medical practice (69 percent), such as prescribing medication without establishing a clinical relationship with the patient

Misrepresenting medical credentials online (60 percent)

The penalties for these online faux pas included reprimands, loss of licence, community service, fines etc.

Taken in totality, doctor behavior both on and off-line has some cause for concern. The same behavior in the real world translates to disruptive behavior online. I would also argue that it’s not just the same behaviors, but also the same set of doctors who misbehave. If you meet a jerk in the real world, chances are it’s the same person that might pursue you on a dating site.

The statistics as reported on Fierce Healthcare are a little fuzzy though. OK, so 69% of the 48 states had at least one reported online misconduct case, but how many doctors were involved? What percentage of doctors displayed inappropriate behavior? Were there repeat offenders, or multiple cases against the same misbehaving doctor? I don’t know. The JAMA abstract is woefully short on any meaningful details.

Does the online world just make this worse? Do we see more of this happening and since it’s so easy to connect with patients online? Does it also make the doctor more accountable for their actions since something done online can be more easily tracked and reported?

EMR Sales at $18 Billion in 2011

Posted on March 23, 2012 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.

Healthcare Financial News posted the following number of the EMR market.

Propelled by government incentives, a desire to improve patient outcomes and the bottom line, sales of electronic medical records reached $17.9 billion in 2011, up 14.2 percent from the previous year, according to market research publisher Kalorama Information.

I’m not sure of the exact EHR incentive figures for 2011, but I have seen the number $3.1 billion paid to 43,000 providers from Justin Barnes. It’s no doubt somewhere in that range and is an interesting number to compare against the $14.2 billion in EHR sales in 2011.

That’s quite a big difference in number. I’m sure many doctors would easily argue that the difference is because the EHR incentive money doesn’t cover all the costs to get an EHR. I’m sure there were also many EHRs purchased in 2011 that won’t see EHR incentive money until 2012. It will be really interesting to see these numbers again at the end of 2012. I also wish they’d have broken the number out by hospital EHR and ambulatory EHR. I have a feeling that hospital EHR software dominates that number.

EMR the 4 Letter Word

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.

Adam Sharp, MD, Founder of par80 and SERMO, has come out swinging on his relatively new blog for his new company par80. One of his first blog posts talked about why EMR is a four letter word for most doctors. The thing is he’s right in many ways.

The first thing he does is debunk the 50% EHR adoption number that’s gone around and been propagated by the ONC and others:

The 50% adoption rates seen in the first link reflect the presence of ANY type of an EMR-like technology. While it is a great headline for sure, the second link shows that this is an overly broad declaration. When we look at “fully functional systems,” meaning they are being used for a full work-flow solution, we get numbers in the low teens instead. (When you subtract out unique situations such as Kaiser, the VA, and a few large independent doctor networks, I suspect the actual number is much lower.)

I personally put EHR adoption at about 25%, but now we’re quibbling over small percentages. Either way, it’s quite low. Adam describes the real challenge that EHR vendors face and how they can remove the 4 letter word connotation of EMR:

Widespread adoption of an EMR (or multiple compatible EMRs) that is intuitive and easy to use, that empowers the end user and patients, and that actually helps to make the healthcare system more efficient would be a good thing for doctors, patients, and the industry. However, unless we recognize what the ultimate goals are and better involve the people most critical to their effective use (physicians), I believe Jonathan’s prediction will be true and cash-for-clunkers applied to the healthcare sector will turn out about as successful as that other government program…TARP.

I think this trend is changing for many EHR vendors that really are trying to focus on the physician, but sadly have this huge distraction called meaningful use. Plus, we are having more doctors write about their good experience with EHR. The more doctors that can say that their desk is clean, their life is better, and they have more time, the more we’re going to see EHR adoption really increase.

Unfortunately, there’s still far too many poorly implemented, poorly selected and poorly accepted EHR implementations out there. This is a tough problem to solve particularly in this government incentivized environment. I think I read recently in a passing tweet something about HIMSS soliciting for more EHR success stories. I don’t think a manufactured list of EHR success stories is going to do the trick. Although, it’s true that EHR failure stories spread faster than EHR success stories.

What do you think will shift the tide of EHR adoption? Is the EHR incentive money going to be enough to change it? We’ve certainly seen some increase in EHR adoption from the EHR stimulus, but will it be enough and in the right direction?

Scanning 101 for electronic doctors’ offices

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.

Know what I did last summer?   Killed some guy on the side of the road.  That’s what I might have said if I were Jennifer Love Hewitt.  Forgive the bad humor.

Actually, I invested in one of the single most valuable pieces of equipment in my office, a high speed scanner.  For the price tag of around $1,500.00, I was able to sidestep hiring another $35,000/year staff member to sit around and scan documents and old medical records all day long on our slow, old scanner.

Our trusty older scanner is part of an HP “all-in-one” printer combo that still sits in our office, performing its job of faithfully printing all of our documents, and scanning a very few documents lately.  The biggest problems with using this older multipurpose machine as a scanner included: (1) inability to print and scan at the same time, and (2) slowness at 5 pages per minute (let me just say, “OH MY GOD! THE PAIN!”).

Trust me guys, get yourselves some of the high speed stuff.  It’s such a joy to use the right tool for the right job.