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Use Of Surescripts E-Prescribing Up Dramatically

Posted on October 21, 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.

E-prescribing has become almost commonplace, if not universally used, among providers with EMRs during the last four years, a new study concludes. The study, which was published in The American Journal of Managed Care, was conducted by a team led by ONCHIT’s Meghan  H. Gabriel, PhD.

Researchers found that between 2008 and 2012, the total number of e-prescribers using Surescripts shot up from 7 percent (47,000 providers) to 54 percent (398,000), according to a report in EHR Intelligence.

As EHR Intelligence notes, these numbers didn’t just appear out of nowhere. Part of the reason e-prescribing has gained so much ground is that 94 percent of pharmacies are now able to accept e-prescriptions, up from 61 percent in December 2008.

It’s a good thing pharmacies are on board. E-prescribing must be in place  — specifically, certified EHR technology (CEHRT) — to meet one of the requirements of Stage 2 Meaningful Use. The requirement is that eligible providers need to transmit more than 50 percent of “all permissible prescriptions” via their CEHRT, EHR Intelligence points out, 10 percent higher than the Stage 1 requirement.

Side note: CMS seems happy with e-prescribing progress to date. According to the agency, more than 190 million electronic prescriptions had been sent by doctors, physician’s assistants and other healthcare  providers using EMRs. That 190 million is the cumulative total sent since the inception of the Meaningful Use program in 2011.

But from my way of looking at things, it isn’t completely kosher that e-prescribing by providers is barely over the half-way mark, despite representing considerable improvement over the years. While 54 percent is a nice round number, it still suggests that nearly half of providers are not equipped to achieve compliance with Meaningful Use Stage 2, an undesirable situation at best.

No, despite the improvement in e-prescribing uptake, to me the current stats actually look like a problem, not a win at this stage. The 46 percent of providers not online with e-prescribing had better get their act together.

CMS Shares Benefits Of Meaningful Use

Posted on July 23, 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.

CMS has released new data which lays out some of the benefits of Meaningful Use since the inception of the program in 2011.  The data outlines various ways in which Meaningful Use requirements have played out statistically.

According to the statement, the following landmarks have been reached over the last few years:

• More than 190 million electronic prescriptions have been sent by doctors, physician’s assistants and other health care providers using EMRs.

• Health care professionals sent 4.6 million patients an electronic copy of their health information from their EMRs.

• More than 13 million reminders about appointments, required tests, or check-ups were sent to patients using EMRs.

• Providers have checked drug and medication interactions to ensure patient safety more than 40 million times through the use of EMRs.

• Providers shared more than 4.3 million care summaries with other providers when patients moved between care settings.

It’s clear from these stats that e-prescribing is on a serious roll — though it’s interesting to me that over the last few years I’ve only had my scripts e-prescribed a couple of times.  Clearly there’s a lot more work to do there despite the large number.

On the other hand, these factoids aren’t staggering given that they’re cumulative over a few years. For example, while it’s encouraging that providers have shared more than 4 million care summaries (Continuity of Care Documents, I assume), that’s still a tiny fraction of the volume that we’ll need to see to say we have anything like real interoperability.

I was actually surprised to see that the reminders issued about appointments, tests and check-ups stood at a relatively modest 13 million. Primary care practices, in particular, are under such pressure to make sure patients hit their marks that you’d think setting up such reminders would be a no-brainer. But apparently it’s not.

All told, the numbers cited by CMS definitely suggest progress, but not as big of a win as the agency might have preferred. Let’s see the numbers for patient data sharing up in the hundreds of millions and then I’ll really be impressed.

Providers In Underserved Areas Lagging On EMR Implementation

Posted on July 11, 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.

Providers in large metros are less likely to have implemented EMRs than those in smaller metro areas and rural areas, according to a study written up by Healthcare Informatics.

The study, which appeared in Health Services Research, set out to determine whether EMR adoption was lower in traditionally underserved areas. To look at this issue, in 2011 researchers gathered data from 261,973 ambulatory healthcare sites with 716,160 providers, covering 50 states and the District of Columbia. Provider sites ranged from one-physician practices to large multi-physician groups, Healthcare Informatics reports.

Researchers found that areas with high concentrations of minority and low income populations, as well as those in large metropolitan areas were more likely to be in the lowest quartile of EMR adoption nationally, as compared with rural areas. The study also found that 43 percent of providers working in ambulatory healthcare sites had EMRs with e-prescribing capabilities, Healthcare Informatics reports.

Clearly, if researchers were expecting to find a lack of EMR adoption in these metro practices, they hit the nail on the head. I’d like to know, however, why things fell out this way.

Are metro practices lacking the resources to adopt EMRs in a more pronounced way than rural practices? Is there some phenomenon in the works in which underserved populations aren’t expecting EMRs, and therefore aren’t pressuring providers to implement them?

It’s worth noting that according to HIMSS data for Q1 2013, about 50 percent of ambulatory providers were still paper-based, and that nearly half of remaining practices were still stuck at Level 3 of adoption (CDR, access to results from outside facilities) or lower.

I’d argue that the gap between practices with mature implementations and those who are barely crawling is of equal importance and worth a study of its own. In the meantime, it is worth considering what can be done — beyond Meaningful Use incentives, clearly, or the gap wouldn’t exist — to be sure that EMR uptake doesn’t hit a snag with metro providers.

Health IT Costs, Health IT Adoption, HIE and CommonWell – Pre #HITsm Thoughts

Posted on June 28, 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.

Last week I took the #HITsm Chat topics and created a blog post about Healthcare Unbound. I enjoyed creating the post so much that I decided to do it again this week. Not to mention I’ll be on the road to Utah during this week’s chat and won’t be able to participate. (Side Note: If you live in Utah and want to do lunch, I’d love to meet and talk EMR or health IT. I’ll be in Hawaii in July if you want to do the same.)

The chat topics make perfect discussion items. Plus, I love that I have more of an opportunity to really dig into the topics in a blog post. You can’t dig in quite as much in 140 characters.

Topic 1: Costs vs benefits. Will high costs always be the #1 barrier cited to #healthIT adoption?
We’ve seen an enormous shift in the cost of healthcare IT since I first started blogging about EMR 8 years ago. Cost use to be a much bigger issue when the cheapest EMR software you could find was about $30,000+ per doctor (in the ambulatory space). Plus, they expected you to pay the entire lump sum payment up front (many did offer financing). These days the cost of EMR software has dropped dramatically and fewer and fewer EHR vendors are using the lump sum payment model. This change means that costs are much more in line with a practice’s revenue.

These days, I’d say that those who use cost as the reason for not adopting health IT are really just using it as an excuse not to do it. There are a few rural providers where cost is more than just an excuse, but those are pretty few and far between. I’m not saying that cost isn’t an important part of any health IT project, but I’ve most often seen cost used as a mask for other reasons people don’t want to implement health IT. The most common reason is actually just a general resistance to change.

Topic 2: Why does ePrescribing have such widespread acceptance while #telehealth adoption is so low?
If providers could be reimbursed for telehealth, adoption would be high.

It is ironic that doctors don’t really get reimbursed for ePrescribing, but they do it at a high level. Although, the doctor does get reimbursed for the visit that generates the need for the prescription. A deeper investigation of why ePrescribing has had good adoption would be interesting. Certainly there are many doctors who miss their sig pad. However, once you have to record the prescription in the EHR, you might as well ePrescribe it.

Plus, there are some obvious reasons why ePrescribing is better. Whether it’s replacing the unreadable prescriptions or the drug to drug and allergy interaction checking that’s built into every ePrescribing platform, the benefits can be understood quickly.

The sad thing is that the benefits of Telehealth can be seen quickly as well, but you can’t get paid to do it.

Topic 3: #HIE as a noun or a verb? Does negative press for HIE org$ hinder health data exchange as a whole?
HIE is currently more of a noun than a verb. Verbs require action and we’re not seeing enough HIE action.

In some ways negative press could discourage healthcare organizations from participating in an HIE organization. However, negative press about HIE’s weaknesses can also put pressure on healthcare organizations to finally step up to the plate and have more HIE action and less HIE talk.

The biggest hindrance to HIE is business model, and good or bad press won’t do much to change that.

Topic 4: Is #CommonWell just a bully in a fairy godmother costume?
I love this question mostly because I sent the tweet that inspired it. Although, a smart health IT PR/marketer was the one who said it to me.

It’s a little too early to tell if the fairy godmother costume that CommonWell has on is real or fake. I think there path is paved with good intentions, but will the almighty dollar get in the way of them realizing these good intentions? I don’t know. I’m hopeful that it will be a success. I’m also glad that at least the conversations are happening. That’s a step forward from where we were before CommonWell.

Topic 5: Open forum: What #HealthIT topic had your attention this week?
There are so many topics that I discuss each week, but I think I’m most excited by the project announced this week to create a Common Notice of Privacy Practices. I hope their crowdfunding is successful and they get a lot of great healthcare organizations on board with what they’re doing. I also found the Vitera Healthcare acquisition of Success EHS quite interesting. EMR is slowly but surely consolidating.

Highlights for the eRx Incentive Program

Posted on June 12, 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’m a numbers kind of guy and so I love all of the data that’s being put out by ONC, CMS and HHS about the incentive money they’re paying. Granted, they’re a little late with some of the data, but at least they’re working towards the goal of more transparency.

CMS just released the data for the 2011 PQRS and eRx incentive program. In 2011, the PQRS and the eRx Incentive Program paid a combined total of $546,782,339. Here are some other report highlights:

Report Highlights for PQRS

  • In the 2011 program year, 280,229 eligible professionals participated individually in PQRS
  • CMS paid a total of $261,733,236 in PQRS incentive payments for the 2011 program year

Report Highlights for the eRx Incentive Program

  • In the 2011 program year, 282,382 eligible professionals participated in the eRx Incentive Program, a 116 percent increase from total participants in 2010
  • CMS paid a total of $285,049,103 in eRx incentive payments for the 2011 program year
  • 135,931 eligible professionals were subject to the 2012 eRx payment adjustment because they either did not qualify for an exemption, did not meet exclusion criteria for the adjustment, or did not meet eRx reporting requirements in the first half of 2011

To review the full report, visit the CMS PQRS website. For more information about PQRS, eRx, and other eHealth initiatives at CMS, visit the CMS eHealth website.

EMR, HIE Use Up Sharply In U.S.

Posted on May 10, 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 survey by Accenture has concluded that the number of U.S. doctors using EMRs — either in their practice or at a hospital — has climbed to over 90 percent, and that almost half are using HIEs. More than half of doctors surveyed (60%) report using an EMR in their own medical practice.

The Accenture survey reached out to 3,700 doctors in eight countries, including Australia, Canada, England, France, Germany, Singapore, Spain and the U.S.  Data showed a spike in healthcare IT usage across all of the countries surveyed.

In the U.S., doctors had the biggest increase in adoption demonstrated in the survey, up 32 percent in routine use of health IT capabilities, as opposed to an average increase of 15 percent among non-U.S. clinicians, reports HealthcareIT News.

Other standout activities were e-prescribing (65 percent using) and entering patient notes into EMRs (78 percent), a 34 percent annual increase between 2011 and 2012. Forty-five percent of physicians also use IT for basic clinical tasks such as getting alerts while seeing patients (45 percent), according to Healthcare IT News.

Healthcare IT News also caught an interesting detail around lab orders. The magazine notes that 57 percent of U.S. doctors said they regularly use electronic lab orders  (a 21 percent annual increase) the volume of physicians doing so internationally dropped 6 percent.

Globally, the number of doctors who “routinely” access clinical data on patients seen by different health organizations has climbed by 42 percent, from 33 percent of doctors in 2011 to 47 percent in 2012. Spain was the leader by a significant margin, with 69 percent of doctors routinely accessing such data.

The study also concluded that internationally, almost 60 percent of doctors customarily enter patient notes electronically either during or after consults.

On the other hand, so-called “digital doctors” are still unlikely to connect or transact electronically with outside organizations. Accenture found that only 10 percent of physicians communicate electronically to support remote consults/diagnostics, and that roughly 20 percent e-prescribe, receive notifications of patients’ interactions with other health organizations and communicate electronically with clinicians in other organizations.

Preventable Issues Arise When Paper Documentation is Used

Posted on November 5, 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.

It’s an unfortunate truth that the health care system is not fool proof, and mistakes happen. Many of these mistakes happen because of paperwork that is lost, unreadable, or misplaced. Even with the implementation of EMRs across the country, many healthcare providers are still relying on paper for many aspects of their practice. Referral MD created an infographic that shows some of the current problems in healthcare related to using paper documents:

Pretty scary, if you ask me. Doctor’s are notorious for having terrible handwriting, but 7000 patients die a year because of it? And 30 percent of tests have to be reordered because the orders were misplaced? These statistics are startling, in large part because they are preventable. Those are only two of the facts presented in this infographic, and in combination with everything else, it makes me wonder why anyone that has an EMR would still use paper, and why the practices that don’t use EMRs haven’t started. It makes me not want to trust the system even more.

I can see how patients and doctors alike may find it hard to switch over. When I wasn’t given a physical, paper prescription to take to the pharmacy to get my son’s medication, I was a bit taken back, but it made things so much easier when I actually arrived at the pharmacy. I compare that to the many prescriptions and lab orders I lost during my pregnancy because I set it down and forgot to pick it up again, never to find it again until months later while doing some cleaning. It made me really wish my OB/GYN had electronic documents more incorporated into his practice. I’m curious to see if he has any EMR at all. Since he’s been a doctor for 40+ years, maybe he’s having a hard time making the switch.

It’s one thing if a person dies from a terminal illness, but to pass away because of a preventable mistake is uncalled for. I realize that no one is perfect. Everyone makes mistakes. But when a mistake could mean someone dying, a patient’s information being misused, or a HIPAA violation occurring, something is wrong. Hopefully as EMRs become better and more practices have them, paper documentation will become a thing of the past, and these mistakes, breeches, and all other issues that are related to using paper, will go that way as well.

Upcoding, Presidential Debates, and MU Incentives– #HITsm Chat Highlights

Posted on September 29, 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.

Every week, HL7 Standards, hosts a #HITsm Tweet Chat and poses four questions “on current topics that are influencing healthcare technology, health IT, and the use of social media in healthcare.” It’s always a great discussion and also a great chance to meet a wide variety of people that are passionate about healthcare IT.

In case you missed it, or are curious about what went on this week, we’ve put together the list of topics with some of the best responses for each topic. There were some interesting topics this week, as well as some great responses. If you have any opinions on any of these topics, feel free to continue the discussion in the comments. This chats take place every Friday at 11AM CST. You’ll find members of Healthcare Scene regularly participating in the chat under some of the following Twitter accounts: @techguy@ehrandhit@hospitalEHR, and @smyrnagirl.

Topic One: Big debate now about EHRs sparking upcoding if not fraud. What’s your take? Will inverse be true with digitized health system?

 

 

 

Topics Two: 59% of IT execs say staff shortages harm earning of MU incentives. What is long-term impact if feds HIT education lag demand?

 

 

 

 

Topic Three: What would you ask Obama or Romney about HealthIT, reform law, or healthcare in general during the Oct. 3 debate? 

 

 

 

 

Topic Four: Health IT projects: Which ones are you postponing until after the election? 

 

Can Health IT Reduce Readmissions?

Posted on August 15, 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.

We who work around health IT know it can do some great tricks, but it’s always nice to see examples of how it can actually save money.  One example of how health IT can be a cost-saver is in helping to reduce readmissions, according to a new study from CSC.  Here’s a summary of how it might work, courtesy of CMIO magazine:

Reducing readmissions will require identifying patients at risk for readmission, carefully orchestrated care management programs and patient-specific transition pathways. While this type of patient tracking, collaboration and patient-centeredness has been historically difficult to achieve, health IT should enable more organized care management through tools such as e-prescribing, master patient indexes and electronic clinical communication.

The report notes, however, that this works much better if hospitals and health systems have integrated EMRs that extend from the facility into community medical practices.  And that’s just common sense. After all, hospitals aren’t equipped to check on patients regularly once they’re discharged, aside perhaps from a few that are experimenting with remote monitoring.

The thing is, given that hospitals and medical practices are seldom running the same systems, it’s unlikely (OK, almost impossible) that they’ll be able to share much in the way of digital information. Sure, they’ll get faxes galore, but if that was an efficient way to share docs we wouldn’t be having these conversations.

Oh well. It’s always good for deep thinker types to point the way ahead. Unfortunately, I think we’ll have to wait a while for coordinated care planning via health IT to really find its place. Maybe John’s predictions for Direct Project will help us get part of the way there.

What’s Next For Physician Tablet Use?

Posted on July 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.

Not long ago, Manhattan Research released a study offering details on how doctors’ consumption of digital devices and media is progressing.  The survey, which surveyed 3,015 physicians in 25 specialties, looked at doctors who were online in the first quarter of 2012.

Among the most interesting — if not surprising — findings was that tablets have more or less officially hit the medical mainstream. According to the research firm, tablet use among doctors has nearly doubled since last year, hitting a whopping 62 percent in this year’s study.  You also won’t be shocked to learn that iPads dominate medical tablet use, in part due to their high-res screen and ease of  use.

Why the greater rush to adoption?  I think the following comment, which Monique Levy of Manhattan Research made to InformationWeek, offers a nice insight:   “It used to be that you had to solve the problems of security access, validation, and data security first and then adopt,  (but) what’s happened is that the system has turned upside down. We’re now at adoption first and solve the problem later.”

As Levy notes, the first wave of adoption has been driven largely by access to lower-risk information, and less for patient data. We can expect to another round of resistance when physicians are tethered to EMRs largely by tablets, she predicts.  I’d add that as long as there’s no native client physicians can use to access EMRs on the iPad, it will make things worse.

Given that resistance, maybe medical use of tablets will expand in other areas first. According to IT prognosticators and researchers at the Gartner Group, top medical uses of tablets also include waiting rooms, e-prescribing, diagnostic image viewing and appointment scheduling. (I’m amazed more practices aren’t doing the waiting room check-in thing.) Maybe one of these other areas will evolve breakout apps before doctors are really hooked up with patient data on their tablet.