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10 Tips for Selecting the Right EHR

Posted on November 30, 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 recently stumbled upon the Insight Data Group website. I don’t know much about the organization, but they had an interesting page on their site listing 10 tips for selecting the right EHR. Here are there 10 tips.

  • Make sure the EHR is easy to use and customize
  • Get training and more training
  • Buy the ‘right sized’ solution for your practice
  • Know who’s filing your insurance claims
  • Get and check references
  • Get mobility / portability access
  • Use the government’s money to pay for your EHR
  • Compare total cost of ownership not monthly payments
  • Know the financial stability and reputation of your EHR vendor
  • Make sure your vendor’s meaningful use guarantee is meaningful

They have a full explanation of each tip at the link above, but I thought it was an interesting list to share. I have a little bias for the e-Book I wrote on EHR selection, but this is a good quick list to consider if you’re in the EHR selection and EHR implementation process. I would be careful with the government money recommendation. I’d probably have said, “Consider using the government’s money to pay for your EHR.”

Of course, many of you are likely already past this process. However, I know that many of you will need this list in a year or two when your current EHR software doesn’t deliver what you expected it to deliver. We’re already seeing this now, but the replacement EHR market is going to be huge over the next few years.

New Survey for EHR Etiquette

Posted on November 29, 2012 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.

As more doctors deploy electronic medical record (EMR) systems in their practices, some physicians have reported difficulty balancing bedside manner with inputting information into their EMRs.  With a recent report stating that nearly 70% of U.S. primary care physicians now use electronic medical records, this discussion will be a hot topic moving forward.  A key question is: What’s the best strategy for balancing EMR use and physician/patient interactions?

Denise Amrich wrote on ZDNet Health in July about the Kaiser Permanente method for EHR etiquette.  Called LEVEL, the method advocates:

-Letting the patient look on;
-Eye contact;
-Valuing the computer;
-Explaining what you’re doing; and
-Logging off.

Undoubtedly, some physicians have developed their own best practices for EHR etiquette.  Software Advice is currently hosting a survey to analyze how EMR systems have impacted physician/patient interactions, and what physicians have done to effectively use the technology in their practices.  The survey is only a few questions, and should take only a couple of minutes to complete.

The Software Advice blog is hosting the Patient Interactions with EMR/EHR Use survey.  Data will be collected over the next few months, and a final report and analysis will be shared on the Software Advice blog after the survey has closed.

Homegrown Health IT Innovation Takes Center Stage

Posted on 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.

I’ve had the good fortune over the last few months to be involved in the marketing efforts surrounding the Health IT Leadership Summit happening next week at the Fox Theatre in my hometown of Atlanta. A joint effort of the Technology Association of Georgia’s (TAG’s) Health Society, the Metro Atlanta Chamber of Commerce and the Georgia Department of Economic Development, the annual event does a wonderful job of spotlighting the strides Georgia is making in healthcare IT, both on the provider and vendor sides.

I’m particularly excited to learn more about the four finalists of the Intel Innovation Award, which will be presented to the winner at the summit. I think it’s no coincidence that Solo Health, last year’s winner, has seen a number of newsworthy business developments happen since accepting the award in the Fox’s Egyptian Ballroom last November.

I thought I’d share a brief synopsis of the finalists (courtesy of their respective websites), and then take bets on who will take home bragging rights!

AirWatch (@airwatchMDM)
“AirWatch is the leader in enterprise-grade Mobile Device Management, Mobile Application Management and Mobile Content Management solutions designed to simplify mobility. More than 4,700 customers across the world trust AirWatch to manage their most valuable assets: their mobile devices, including the apps and content on those devices. Our solutions are comprehensive, built on a powerful yet easy to use platform by leaders in the mobile space.”

In a word, it’s all about security in healthcare right now, as iPad minis, iPhone 5s and yes, even a new Blackberry or two make physicians that much more likely to join the BYOD movement. AirWatch is certainly in the game at an opportune time.

CardioMEMS (@cardioMEMS)
“CardioMEMS is a medical device company that has developed and is commercializing a proprietary wireless sensing and communication technology for the human body. Our technology platform is designed to improve the management of severe chronic cardiovascular diseases such as heart failure and aneurysms. Our miniature wireless sensors can be implanted using minimally invasive techniques and transmit cardiac output, blood pressure and heart rate data that are critical to the management of patients. Due to their small size, durability, and lack of wires and batteries, our sensors are designed to be permanently implanted into the cardiovascular system. Using radiofrequency, or RF, energy, our sensors transmit real-time data to an external electronics module, which then communicates this information to the patient’s physician.”

I first came across this company nearly two years ago, when I heard founder Jay Yadav, M.D., speak at a TAG luncheon, and I’ll be eager to see how their technology has evolved since then. From an EMR perspective, I’m especially interested in where the real-time data goes when a physician receives it. Is it fed into an EMR, perhaps? I’m taking a field trip to the CardioMEMS office next week, so hopefully I’ll find out. I’d also like to get their thoughts on the FDA’s move to regulate mobile health apps, which I assume will impact them in some tangential way.

Cooleaf (@cooleafhealth)
“Cooleaf is the easiest way to enroll in classes and programs for your health while earning rewards. Our mission is to harness the power of classes and programs to enhance the well being of the planet. We founded Cooleaf on the following principles:

  • There is no “one size fits all” solution in health and wellness
  • Living a healthy life should be easy
  • If you live a healthy life, you should be rewarded
  • If you live a healthy life and get rewarded, you should own those rewards
  • If you’re guided by experts face-to-face, you’re more likely to achieve your health goals (and enjoy yourself)”

Certainly the most consumer-oriented of the bunch, the Cooleaf website seems like a great way to get employees engaged in wellness initiatives. I wouldn’t be surprised if a few payers start sniffing around as its user base grows, and resource database moves beyond Atlanta-based locales.

Monocle Health (@monoclehealth)
“Monocle Health Data is the only company solely dedicated to providing independent, unbiased healthcare provider ratings and rankings based on both price and quality, for both episodic care and chronic illnesses.

Monocle’s tools – price rankings, quality ratings and analytics-based reporting – are the foundation of true healthcare price and quality transparency.”

As a patient – especially one who is in need of new family physicians – I am especially interested in transparency. How do the doctors in my area stack up against each other when it comes to patient satisfaction, quality and what my hard-earned dollars will get me? As patient engagement efforts continue to take off, so too I think will provider comparison tools such as this.

Only time will tell which of these Atlanta-based companies will win. I’ll follow up in a subsequent post with the victor’s details, and future plans for continuing to change the landscape of healthcare IT.

Are EMRs Going To Generate Billing Audits?

Posted on November 28, 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.

As readers are likely to know, EMRs have already begun to get a bad rap among some payers — most prominently Medicare — as leading to upcoding and padding of services performed on the E/M side of medicine. It may seem a bit unfair for CMS to push for EMR adoption then waggle the finger of disapproval when they lead to billing changes, but that’s how the cookie crumbles.

The thing is, we’re not just talking about disapproval and public chastisements over billing patterns.  HHS has gone a step further than public tut-tutting. In the 2013 work plan for the HHS Office of the Inspector General, the OIG has specifically targeted EMR documentation for E&M services  as an area for study and possible audits:

We will determine the extent to which CMS made potentially inappropriate payments for E/M services in
2010 and the consistency of E/M medical review determinations. We will also review multiple E/M
services for the same providers and beneficiaries to identify electronic health records (EHR)
documentation practices associated with potentially improper payments. (emphasis mine)

According to Betsy Nicoletti, a prominent coding consultant who chatted with me this week about this topic, the OIG is going all out this year, looking at Medicare A, B, C, D and just about every type of provider you can imagine (such as, for example, skilled nursing facilities). Private payers are also getting particularly aggressive in looking for suspect billing patterns, particularly profiles that don’t fit with other physicians in a given specialty.

From what she told me, it’s not that EMRs are automatically suspect, but rather, that EMRs can create inconsistencies and red-flag billing patterns through the use of templates and forms.  For example, CMS may very well notice and audit your practice, she says, if the use of templates leads to using the same code too often (something CMS frowns upon, as it assumes patients’ conditions will vary widely).

If you want to get ahead of possible OIG audit problems, she suggests physicians read the work plan and self-audit in areas that are relevant to their medical practice.  Better safe than sorry, no?

MU Stage 3 Comment Period and Hospital EHR Attestation Deadline Approaching

Posted on November 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.

HIT Policy Committee sent out an email with a request for comments on meaningful use stage 3. Here’s the email that was sent out:

Speak up now to help ONC’s Health Information Technology Policy Committee (HITPC) develop Stage 3 meaningful use recommendations that will target a collaborative model of care with shared responsibility and accountability, building upon previous meaningful use objectives through the Request for Comment.

The comment period is now open. Each item that the HITPC is requesting comment on has been given an identification number in order to streamline the accumulation of comments. Please use this ID number when submitting comments. Submit a comment online.

The deadline for comments is 11:59p.m. ET on January 14, 2013.

Following the analysis of the comments received throughout the comment period, the HITPC intends to revisit these recommendations in its public meetings in the first quarter of 2013.

Also, for those Eligible Hospitals and Critical Access Hospitals (CAHs), the last day for you to register and submit attestation in fiscal year 2012 for the Medicare EHR program is November 30, 2012. For eligible hospitals and CAHs, this means that they must successfully attest to meeting meaningful use to be eligible to receive an incentive payment for FY 2012.

CMS has also put together this PDF of the meaningful use and EHR incentive timeline. Be careful so you don’t miss any deadlines.

HIT Acronyms Leave Me Needing a Nice Glass of Wine

Posted on 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.

I had quite a learning curve to overcome when I first started working in and writing about healthcare nearly four years ago. I quickly realized that industry insiders peppered their conversations, blogs, tweets and presentations with acronyms that no mere mortal (or patient) could be expected to easily derive definition from. Only after months of immersion was I able to grasp the meaning of acronyms I heard on an everyday basis.

I was reminded of this when several popped up during a recent #HITsm tweetchat.

Gregg Masters, i.e. @2healthguru, made a good point in response:

Is healthcare as an industry alienating patients with this type of healthcare-ese? Do healthcare acronyms make patients feel less confident when speaking with care givers – perhaps more willing to gloss over certain issues because they are not confident in their understanding of certain terms and conditions? I can only imaging how amplified this problem is with the non-English speaking.

As we spend time talking about patient engagement and education, let’s not forget that concepts and terms that we take for granted may not be fully understood by the majority of healthcare consumers. Care givers should set aside time with patients to ensure everyone is on the same page when it comes to understanding healthcare terms.

That being said, the next time new healthcare acronyms crop up, I’ll kick back and have a glass of wine before diving into definitions.

Allscripts MyWay to Allscripts Pro Migration

Posted on November 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.

We’ve been tracking the major news that Allscripts was discontinuing MyWay since the news first came out. One of the major questions I had was how the VARs were going to react to the news. Aprima has made a big case for MyWay users to go with them and they have a pretty compelling case to make.

I got an email that a VAR sent out to its users that makes a pretty compelling case for Aprima versus Allscripts Pro. I copied part of the email below. When you look at the list of items that won’t be moved from Myway to Allscripts Pro, I think my prediction that few users will make that transition is ever more solid. Although, the question still remains how many will go with Aprima versus some other EHR. If Aprima does a solid job with the VARs, then it could be a really big win for them.

Here’s part of the email the VAR sent:

Aprima’s Upgrade Program Gives You…

  • Free Aprima licenses for Allscripts customers whose product is being migrated – no need to re-buy software!
  • Same core product – the Allscripts product being migrated started as Aprima 2008
  • Same look and feel with nearly 1,000 enhancements
  • Minimal learning curve of new features, minimal to no downtime
  • Your existing data intact; this is a proven product upgrade, not a conversion
  • Live webinars and on-site training available
  • Ongoing upgrades and development of the product, no end of life sun setting
  • Product will meet Meaningful Use and support ICD10
  • Support is U.S.-based

It is important to note with the migration to Allscripts PRO, data will be exported from one system into another and not all data will come across during this process.  MyWay and PRO are very different.  As a result, you will need to be retrained on the new system and create new workflows. Most significantly, none of the financial data will be included, so you will be left with running down old balances in MyWay while setting up the new PRO PM. See below for a list of data points that will not be migrated:

  • Financial Transaction Data
  • Financial History, Superbills, Payment, and Adjustment transaction detail will not be migrated into the Allscripts PM system.
  • Allscripts MyWay clients will continue to use their current system to work down their previous Accounts Receivable for a period of time.
  • Current Patient account-forward financial balances in Allscripts MyWay will not be migrated to Allscripts PM.
  • PM reporting details and history will not be migrated from Allscripts MyWay into the Allscripts PM system.
  • Practice management reports will be replaced by the Allscripts PM reporting capabilities.
  • Insurance claim status and reimbursement history will not be migrated from Allscripts MyWay into Allscripts PM.
  • The Integrated Easy Pay credit card processing feature in Allscripts MyWay is not compatible with Allscripts PM and will not be migrated. Clients can use the Intuit Pay Page functionality in Allscripts PM or use a non-integrated credit card solution for credit card processing.
  • Allscripts MyWay Audit Trail detail will not be migrated into Allscripts PM.
  • Will require retraining for you and your staff
  • Will require additional data conversion
  • Online training + potential weekend time if you want live, hands-on sessions
  • Possible reduced patient load during transition

Motivating Factors for Doctors and Hospitals to Participate in HIE

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.

While attending the Digital Health Conference in New York, I had the chance to sit down and talk with Paul Wilder, Director of Product Marketing and Adoption for the New York eHealth Collaborative (NYeC). I was really impressed by Paul’s understanding of the benefits and challenges of an HIE. He knows them first hand with NYeC’s SHIN-NY project which is connecting all of the various HIE’s and RHIO’s in New York.

I pulled out my camera and asked Paul to talk about the motivating factors for doctors and hospitals to participate in an HIE. I think you’ll enjoy Paul’s answer in the video below. He brings up some ideas related to HIE that I hadn’t heard articulated that way before.

Disaster Planning, Horrors of Generic HIT Training, and Snap.MD: Around Healthcare Scene

Posted on November 25, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

EMR and HIPAA

Disaster Planning and HIPAA

Unfortunately, it appears that far too many healthcare providers don’t follow this rule. There aren’t very many that even have an emergency plan in place. However, this will soon need to be remedied. HIPAA security general rules state that not only must a patient’s privacy be protected, but the ePHI is available at all times — even in the case of an emergency. All healthcare providers, regardless of size, will need to implement some kind of disaster planning, regardless of their situation, in order to be in compliance with these regulations.

EMR Add-On’s that Provide Physician Benefit

MedCPU is a part of the inaugural NYC Digitial Health Accelerator class. They have developed a new concept that will likely to very helpful to many. It analyzes free text notes and structured data, and checks for compliance with rules and to identify any deviances. The company described one hospital using the services the company provides as a benefit given to doctors who use EHR. This is just one of many add-ons available, but some are seeing them to be a large reason why some doctors want to adopt EMRs.

Hospital EMR and EHR

Video: The Horrors of Generic HIT Training

Need a break from the day-to-day monotony? Be sure to check at this video on the horrors of generic HIT Training. It “offers a wry take on what happens when EMR training isn’t relevant for the doctor who’s getting the training. In this case, we witness the plight of a heart surgeon who’s forced through a discussion on primary care functions that she neither wants nor needs.”

Study: EMR ROI Stronger In Low-Income Setting

A recent study revealed something interesting. Hospitals in low-income areas actually may have a decent return on investment when an EMR is integrated. Three different areas were looked at and analyzed, and it was found that after five years of having an EMR, the hospital examined had a net benefit of over $600,000. Not all hospitals will benefit this much, but it’s encouraging to see more EMR success stories popping up.

Smart Phone Healthcare

Get Peace of Mind and Avoid the ER With Snap.MD

It’s the middle of the night, and your child breaks out in a rash all of his or her body. The doctor’s office doesn’t have middle of the night, on-call doctors, so the only option is the ER, right? Maybe not for long. Snap.MD, a new telemedicine system, may help parents decide if the Emergency Room is the best course of action. Parents of pediatric patients are connected to physician, who will help evaluate the situation via video conferencing.

Early Signs Of EMR Consolidation Appearing

Posted on November 23, 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.

Some of you are going to tell me that I’ve jumped the gun, but I’ve got my feeling about this and I’m sticking to it. Though nothing massive has happened yet, I believe we’re officially beginning to see consolidation in the EMR world.

I was struck with this idea today when I came upon the news that physician EMR company Imagine MD was closing. According to MedCityNews.com, the cloud-based EMR company had pulled in $25 million in venture money, $10 million of that in the last 12 months. And until recently, it looked as though it had staying power; Imagine MD had been in business since 2006, well ahead of the pack of competitors pitching small medical practices.

Another sign that we’re seeing consolidation comes in the form of the acquisition of Amazing Charts by Pri-Med, a provider of professional medical education to more than 260,000 clinicians. (I wouldn’t have expected a medical education company to be the one to acquire Amazing, but that’s a story for another time.)

While I admit two examples isn’t exactly a statistical bump, it’s a clear enough sign for me that the market has begun to pull together. After all, with EMR adoption on the rise among medical practices, there’s only so many customers left to compete for, and that can only mean more closings and M&A.

The really important question, if you’re a doctor hoping to avoid a big practice disruption, is whether you can predict which direction your present or future EMR vendor is going.  That is, of course, a pretty tricky game.

But if you’d like some food for thought, you might consider checking out a previous post by John, comparing “fast EMR companies” fueled by venture capital to slower-moving types that grow organically and don’t tend to accept venture capital investments.

While there are exceptions — notably Practice Fusion, which seems to have an extremely solid business — the tech business is rife with examples of fast companies that soared high on venture capital drafts then plummeted to earth.  I’m not suggesting that you should avoid VC-backed EMR firms, physicians, but I am suggesting that you find out as much as you can about the size of their customer base, finances and strategy before you commit your business into their hands.

Otherwise, you could end up like ImagineMD’s EMR-less customers. And if that’s not a bummer I don’t know what is.