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Martin Luther King Jr. Holiday

Posted on January 21, 2013 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’ve mostly taken the day off today since my kids are out of school for the Martin Luther King Jr. Holiday. I have been keeping an eye on the Presidential Inauguration and its messages for healthcare.

Outside of that, my plan is to take a bit of a break from work and spend time with my kids. I know that between now and HIMSS is a complete sprint for me and so it’s nice to have a little break before I start sprinting.

I always take a second to think about and thank all those healthcare workers who don’t have today off because healthcare never stops. I’m deeply appreciative to those who make that sacrifice. Some try to diminish that sacrifice by saying it’s their job, but that doesn’t change the sacrifice in my mind. Particularly because it’s true on every single holiday.

For those of you not working, what’s your plans for today? Anything fun and exciting? We’re thinking about taking our kids hiking. Yes, that’s the beauty of living in Las Vegas.

I woke up this morning to my son making a 3 course breakfast for my daughter (cereal, pancakes, and toaster strudel). Sometimes it’s the little things in life that make it wonderful. Considering the battles my son and daughter have had, it’s nice to see him do something nice for her.

I hope everyone has a wonderful Martin Luther King Jr. Holiday.

MyPassport, Transcription Costs, and CDC App — Around Healthcare Scene

Posted on January 20, 2013 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.

Hospital EHR and EMR

Hospitals Beware: EMR Copy and Paste Common

EMR Templates can be helpful, but also makes life harder as well. A recent study found that 82 percent of progress notes by residents had 20 percent or more copied and pasted material. This function is tempting for physicians who need to cut time somewhere, but its something that needs to be watched out for and prevented.

iPad App Helps Patients Understand Inpatient Care Process

In an effort to eliminate confusion that often comes during an inpatient stay, Boston Children’s Hospital has developed an iPad app. The app, called MyPassport, helps patients understand more about what is going on during their stay. It displays photos of doctors and nurses, others involved in care, as well as lab results that have been condensed to patient-friendly terms.

EMR, EHR, and HIPAA

EHR Benefit — Transcription Costs Savings

This is the next part of the EHR benefits series. Many doctors were thrilled to give up their transcription for an EHR in hopes of saving costs. However, some are feeling that their EHR may not be the best solution after all. Because of this, some are wanting to implement transcription services again. So, for some, eliminating transcription may not have saved as much money as some had hoped.

Mixing Physical, Mental Health Data Lowers Readmissions

Physicians aren’t often given access to the psychiatric records of patients they are treating. However, a study by Johns Hopkins found that perhaps they should be. The study showed that a signficant percentage of patients whose physicians had access to both physical and mental health data had a smaller readmission rate than those whose mental health records weren’t available.

Smart Phone Healthcare

CDC Launches New Mobile App

The CDC is getting into mHealth with the recent release of their mobile app. The app has many different features, such as health articles, quizzes, and a news room with information outbreaks or other pertinent information. The app is free and definitely one that should be downloaded if you enjoy hearing about health news.

Google Gets Into Activity Tracking

After the failure of Google Health, Google is making an attempt to get into the activity tracking world. “Google Now” basically turns the phone into a personal tracking device, including for fitness. It isn’t as accurate as some of the more sophisticated tracking devices out there, but it is a lot easier to use because it is embedded into the phone. It may make it easier for people to

Opportunities For mHealth In The Future: #HITsm Chat Highlights

Posted on January 19, 2013 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.

Topic One: Where areas hold the biggest opportunities for #mHealth apps? Consumer health? Apps for providers? Apps for insurers?

Topic Two: How can we deliver #mHealth apps with the quality healthcare consumers expect? Is it best to focus on non-regulated areas?

Topic Three: When do you see #mHealth really hitting the mainstream? What needs to happen/change first?

Topic Four: Other than #eHealth accelerators, how can we bolster innovation in the #mHealth space?

EMR Quality Data May Not Be Very Accurate

Posted on January 18, 2013 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.

A new study suggests that the quality data residing in EMRs may or may not reflect the actual state of the patient population. The study, which appears in the Annals of Internal Medicine, concludes that the accuracy of EMR-based quality measures can be questionable, sometimes overestimating and sometimes underestimating the delivery of quality care.

The study, done by Weill Cornell Medical College, analyzed clinical data from EMRs run by one of the largest community health center networks in New York state, reports Healthcare IT News.  Researchers from Weill Cornell looked at the accuracy of EMR reporting for 12 quality measures (11 of which are Meaningful Use standards).

After comparing their analysis with a manual check, researchers found that in three areas, reports drawn from EMRs weren’t as accurate as they should be. They underestimated the percentage of patients getting prescriptions for asthma and those getting vaccinations to protect against bacterial pneumonia. Another problem measure predicted that more patients with diabetes had healthy cholesterol levels than actually did.

What’s causing the gap in accuracy? For one thing, doctors and nurses entering data in EMRs may be entering data in fields that aren’t being captured by quality reporting algorithms, HIN’s piece suggests.

While the story doesn’t say this, I think there’s also some gaps in quality reporting generally which have existed since well before EMRs became commonplace.  I don’t know how to address the issue — other than perhaps appoint a nurse-manager to track the progress of quality reporting and ride herd on their colleagues — but given how important quality reporting is, it seems that it will be necessary to devote more resources to the problem.

Finding the Silver Lining in EMR Investment

Posted on January 17, 2013 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.

It’s been a week of doom and gloom news as far as healthcare IT goes. Apparently, providers aren’t seeing the ROI they’d hoped for from EMRs, and as I’m sure you’ve heard, RAND researchers have found that, despite predictions to the contrary some years ago, healthcare IT does not actually save money. Couple these with the 2% hike in social security tax everyone is seeing in their paychecks this month, and it’s easy to understand why the healthcare community might be a bit grumpy.

I’m here to propose that providers try to look on the bright side when it comes to recouping some of that EMR investment. Telemedicine programs may hold a ray of hope for providers looking to find additional value in their EMR. These programs, in my opinion, have gained a strong foothold in the healthcare industry – providers, payers and patients are certainly showing interest, especially given the industry’s stance on readmissions these days; the government seems supportive; and vendors are always eager to provide more product to willing customers.

Here are just a few of the telemedicine highlights I’ve come across in the last few weeks:

* A proposed bill in the House backed by the American Telemedicine Association – The Telehealth Promotion act of 2012 – would potentially expand telemedicine programs in Medicaid and Medicare programs, federal health employee plans, the VA, and others

* The federal government has set aside $1.9 million as part of its Telehealth Resource Center Grant Program in the hopes of expanding its current network of 14 centers to 20.

* The FCC will offer qualifying healthcare facilities up to $400 million annually as part of its Healthcare Connect Fund, which seeks to accelerate development of broadband networks in rural areas.

My thinking is that we’ll see these telemedicine initiatives grow as physicians become more scarce (at least in non-metropolitan areas), coordinated care programs increase, payers look to play a part in wellness programs and preventing readmissions, and everyone continues to look for ways to drive down costs. And from what I’ve read, I don’t see how a hospital or physician’s practice can successfully or meaningfully (pardon the pun) participate in a telemedicine program without an EMR.

Which brings us back to the bad news above. EMRs in recent years have mostly been designed with Meaningful Use measures in mind, not telemedicine, and so might not be adequately equipped to integrate data from teleconsultations. This is where vendors come in. If BCC Research’s prediction of the telehospital market growing to $17.6 billion in 2016 is true, they’ll come in droves. They’ll get to that value by working with hospitals and physicians that want to further their telemedicine programs, and will likely be looking for ways to increase the functionality of their EMRs as a result.

As many of us head to HIMSS in a few weeks, it will be interesting to see if providers really are as disgruntled with HIT expenditures as the media would have us believe, and how much play is being given to telemedicine in the educational sessions and on the show floor.

What is your opinion? Do you currently participate in any sort of telehealth program? Do they have the ability to make EMRs more useful? Please share your thoughts in the comments below.

Meaningful Use Attestation Deadline for 2012 and MU Stage 2 Testing Ready

Posted on January 16, 2013 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.

Eligible professionals (EPs) who participated in the Medicare Electronic Health Record (EHR) Incentive Program in 2012 must complete attestation for the 2012 program year by February 28, 2013. In order to be eligible to attest you must have completed your 2012 reporting period by December 31, 2012.

CMS encourages Medicare EPs to register and attest as soon as possible to resolve any potential issues that may delay their payment.

Medicaid EPs should check with their State for their attestation deadline.

Resources from CMS
CMS has several resources located on the EHR Incentive Programs website to help EPs properly meet meaningful use and attest, including:

Also, for EHR vendors, ICSA just announced that they are now set to begin testing EHR software for meaningful use stage 2. That’s right. Meaningful Use stage 2 is just around the corner.

A Practice’s View of ICD-10

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.

In our recent article about AMA’s call to Halt ICD-10, we got a really interesting practice perspective on ICD-10 that I thought I’d share. The comments come from Sue Ann Jantz who works at a medical practice. Sue brings up some really interesting points that I think are on the minds of many practices and doctors. The final one about 3rd party payer systems is an important one.

In your recent article
The American Medical Association’s most recent call to halt implementation of ICD-10 codes brings to light an interesting angle to the coding story – one that I hadn’t recognized until I read up on just why the AMA has consistently made it known that the switch is a bad idea.

My two cent’s worth:
See, all of the coding changes are going to fall on the physicians — they won’t be able to pawn it off on anyone else, like a nurse or a coder/biller or an administrator. Remember, they do MEDICINE, not transcription, billing, personnel or business.

This is especially true of docs in large organizations such as hospitals and multispecialty clinics (MSC), who believe they have to do all the extra preventative care things because the government tells them to — not realizing that the incentive payment has some administrator licking their chops. As far as most Admins are concerned, getting the docs to do extra work doesn’t cost the hospital or MSC anything, so, why not?

Add to that the perfect storm that’s brewing: HITECH act —> electronic records and meaningful use (MU), ACA —> ACOs and reconfiguration of alliances, and then ICD-10 —-> total rearrangment of charting/documenting (plus the unknown).

And you are surprised there’s smoke coming out of the AMA’s ears? Personally, I am concerned there will be meltdown in the medical community. As far as most of them are concerned, this is all Obama’s fault, and they are furious and busy telling everyone who comes in that Obama is the devil. Granted, those that blame Obama are the one I’ve heard — so that’s probably a limited group in Kansas.

At a coding seminar recently, the presenter asked how many were going to get out before ICD-10 kicked in. Most of the room of 50 people raised their hands – about 80 percent. Further, they said their physicians were going to retire before that happened as well. ICD-10 is slated to go into effect Oct. 1, 2014. Everyone is supposed to be signed up for health insurance by Dec. 31, 2014, bringing anywhere from 15 million to 30 million people into the health care system looking for a provider.

Do you think this might be a problem?

That said, individually, all three of these things are long overdue. Had each been done when they needed to happen, we wouldn’t be in this fix now. Plus, ICD-10 will go into effect and a few months later, ICD-11 will be implemented everywhere else in the world — some think we should skip to ICD-11 … but we probably have enough on our plates at the moment.

Politically, Sebelius has to get this done before the end of Obama’s term. I hope it doesn’t crash us. I am working on it all as if it’s all going to happen. We are not part of an ACO, we probably won’t get to MU1 even though we are working on it because there isn’t enough money in it, although we did do the Adopt/Implement/Upgrade part of the HITECH act. So, that only leaves ICD-10. and I am working on our templates, those instruments of the devil by Sebelius’ standards. Without templates, we wouldn’t have a prayer.

And none of this addresses the 3rd party payer systems … which will probably crash if the early tests are indicative. That means we will not get paid. So I am stockpiling money for that time now.

EMR A Disappointment In The US?

Posted on January 15, 2013 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.

Twitter has been circulating tweets discussing whether EMR is a disappointment in the USA. I find the question really intriguing. I’m sure the doctors who have their EMR and love the benefits they’ve gotten from EMR think its far from a disappointment. The doctors that have an EMR forced on them or select one that kills their workflow likely see EMR as a huge disappointment. Whether EMR is a disappointment in the US starts with which group you think is larger.

My personal gut feeling is that it’s likely split somewhere down the middle. About half of doctors are satisfied with their EMR, and half of doctors are unsatisfied (some might use a much harsher word) with their EMR software.

Does that mean that EMR is a disppointment in the US? I’d have to say it does.

Although, I think that disappointment is the right word. It’s not that I think we shouldn’t be doing EMR. We absolutely should be making physician documentation electronic. As I’ve been starting to highlight in my EMR Benefit Series on EMR and HIPAA, there are some major issues with paper charts that are easily solved with EMR.

The reason EMR has a been a disappointment to date is that EMR implementations can be so much better than they are today.

I believe we are sitting on so much possibility when it comes to how healthcare IT can transform healthcare. For a myriad of reasons, we’re not seeing that potential and quite frankly that’s disappointing.

Health IT Doesn’t Save As Much As Hoped Due To Interoperability Failures

Posted on January 14, 2013 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.

Does health IT actually save money for health organizations?  That’s a billion-dollar question — one which the whole Meaningful Use program rises or falls, I’d argue — but it still hasn’t been resolved. For what it’s worth, though,  here’s some thoughtful input on the subject.

According to a new study appearing in the journal Health Affairs, always the class act of the health policy game, health IT isn’t generating cost savings because of slow adoption and limited interoperabilityiHealthBeat reports. The research was conducted by the RAND Corporation.

Specifically, RAND researchers say, the productivity and cost benefits of health IT have been held back by:

* Slow adoption
* Reluctance of many clinicians to burn the midnight oil needed to truly master such systems
* Failure of the healthcare system as a whole to implement process changes needed to realize health IT system benefits

Another big issue is lack of interoperability between many health IT systems, the RAND researchers said. They note that previous predictions about health IT savings assumed that systems would be connected, thereby increasing efficiency.

To get savings from health IT, the U.S. healthcare industry needs to do the following, RAND says:

* Patients should be able to access their electronic health data and share those records with other health care providers
* Health care providers should be able to easily use health IT systems across different health care settings
* Health information stored in one IT system should be retrievable by health care providers that are part of other health care    systems
* Health IT systems should be set up to support — rather than hinder — the work of clinicians

No one of these points should come as a surprise, but given the stakes involved, it doesn’t hurt to hammer them home again. The whole interoperability “thing” isn’t going away…

Call to Halt ICD-10 Puts New Angle on Demand for Physicians

Posted on January 12, 2013 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.

The American Medical Association’s most recent call to halt implementation of ICD-10 codes brings to light an interesting angle to the coding story – one that I hadn’t recognized until I read up on just why the AMA has consistently made it known that the switch is a bad idea.

The association believes transitioning to the new, 68,000 codes will place too much of a financial and administrative burden on physicians (especially small practices), and will ultimately force many of them to shut their doors.

Attending education sessions at AHIMA last fall left me with the impression that though learning the new codes and suffering through dual coding wouldn’t be fun, they would ultimately help physicians and hospitals receive proper reimbursement for their services. Yes, there were vendor cheerleaders on many panels, but the logic made sense even to a novice like me.

I realize that physician practices are quite a different kind of beast when it comes to handling administrative tasks, and I can certainly understand how a small practice would feel completely overwhelmed when, as the AMA stated in a letter to CMS, overlapping federal regulations combined with predicted Medicare pay cuts will make switching to ICD-10 a huge difficulty for them.

But I feel as if there’s a catch 22 here. If physicians don’t make the switch, they won’t see the potential financial benefits of more accurate coding. If they do make the switch, they’ll likely face such huge financial strains that they’ll opt to go out of business. Are there any physician readers out there who are cheerleading the ICD-10 switch?

It occurred to me, reading recently about the predicted banner year for physicians seeking hospital employment, that physicians that do decide to close their doors as a result of ICD-10 may contribute to this glut of MDs looking for work.

Perhaps there’s a domino effect waiting to happen – CMS stands firm on the ICD-10 deadline / Physicians work incredibly hard to try and make it happen. / Physicians fail and go out of business, or decide early on that it’s just not worth the trouble and close up shop. / Said physicians seek hospital employment. / There aren’t enough hospital jobs to go around and many MDs are left in the unemployment line.

That’s just one scenario I’ve been mulling over, and of course doesn’t take into consideration the large amount of other challenges facing physicians right now. What’s your take on the ICD-10 and physician staffing situation?