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Unbundling EMR, First eRx, Essential EMR, and “Know Your Strengths”

Posted on November 17, 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 think the concept of unbundling the EMR is really interesting. I’m not sure I agree with some of the classifications, but I can definitely see a model where much of the EMR system is done by separate software. Reminds me of the good old days where people were talking about clinical groupware. Same concept, but described a different way.


I love that this was shared on Twitter. Props to Doctor Natasha for sending it. It is very exciting to do. Although, I think the more interesting part of this tweet is the flood of responses Doctor Natasha got from so many other doctors. Check them out here.


I’m not sure what I think about Epic on Steroids. Considering the amount of configuration to make Epic work in your organization, I guess every organization needs to infuse some steroids into it. I was intrigued by the last comment about not imagining taking care of patients without it. This is a growing contingent of doctors. Soon we’ll see the shift where EHR is just a feature and not the future.


Nice tweet during the Digital Health Conference. It’s always great for any organization to know what they’re good at and what they’re not good at. Although, it’s much harder for an organization to actually do it. We’d all like to think we could do anything great, but the reality is much different. Realizing this takes quite a bit of humility. The question is whether you’ll be compelled to be humbled (ie. Failed EHR implementations) or whether you are honest enough with yourself to recognize your strengths and weaknesses.

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.

June 30 eRx Deadline and EHR Incentive Deadlines

Posted on June 6, 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.

eRx Deadline

A major Electronic Prescribing (eRx) Incentive Program deadline is approaching for both individual eligible professionals (EPs) and group practices participating in the Group Practice Reporting Option (GPRO).  If you are an EP or an eRx GPRO participant, you must successfully report as an electronic prescriber before June 30, 2013 or you will experience a payment adjustment in 2014 for professional services covered under Medicare Part B’s Physician Fee Schedule (PFS.)

The 2013 eRx Incentive Program 6-month reporting period (January 1, 2013 to June 30, 2013) is the final reporting period available to you if you wish to avoid the 2014 eRx payment adjustment.

If you do not successfully report, a payment adjustment of 2.0% will be applied, and you will receive only 98.0% of your Medicare Part B PFS amount for covered professional services in 2014.

Avoiding the 2014 eRx Payment Adjustment 
Individual EPs and eRx GPRO participants who were not successful electronic prescribers in 2012 can avoid 2014 eRx payment adjustment by meeting specified reporting requirements between January 1, 2013 and June 30, 2013.Below are the 6-month reporting requirements:

  • Individual EPs – 10 eRx events via claims
  • eRx GPRO of 2-24 EPs – 75 eRx events via claims
  • eRx GPRO of 25-99 EPs – 625 eRx events via claims
  • eRx GPRO of 100+ EPs – 2,500 eRx events via claims

Exclusions and Hardships Exemptions
Exclusions from the 2014 eRx payment adjustment only apply to certain individual EPs and group practices, and CMS will automatically exclude those individual EPs and group practices who meet the criteriaCMS may exempt individual eligible professionals and group practices participating in eRx GPRO from the 2014 eRx payment adjustment if it is determined that compliance with the requirements for becoming a successful electronic prescriber would result in a significant hardship. Requests for hardship exemptions must be submitted byJune 30, 2013. More information on exclusion criteria and hardship exemption categories can be found on the Electronic Prescribing (eRx) Incentive Program: 2014 Payment Adjustment Fact Sheet.

EHR Incentive Deadlines

July 3, 2013 is last day that eligible hospitals and critical access hospitals (CAHs) in their first year of participation of the Medicare EHR Incentive Program can begin their 90-day reporting period to demonstrate meaningful use for Fiscal Year (FY) 2013. Hospitals in their second and third years of participation must demonstrate meaningful use for the full FY. 

Looking Ahead
Three other important dates for eligible hospitals and CAHs include:

  • September 30, 2013—Last day of the FY 2013, and the end of the reporting year.
  • October 1, 2013—First day of FY 2014, and the start of Stage 2 for hospitals in their third or fourth years of participation.
  • November 30, 2013—Last day to register and attest to receive an incentive payment for FY 2013.

See other 2013 important dates in the 2012-2014 Health Information Technology timeline.

ePrescribing and Bowel Movements

Posted on April 9, 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.

Someone recently asked me to comment on my use of electronic prescriptions.  In general, I love them, especially since the old-fashioned method of paper prescriptions is notoriously prone to problems and/or failure on many levels.

1.  Paper scrips take longer to produce by handwriting than typing in a typical electronic e-Rx module.

2.  Patients can lose the scrips.  I once wrote out 15 paper scrips, painfully, during a dinner with friends in a restaurant while we were waiting to be seated.  (To think that I actually wasted a stamp on this.)  Two weeks later, the patient called and said she had lost them and wanted me to send them again.  Fool me once …

3.  Pharmacists can have trouble reading the scrips.

4.  Certain scrips for controlled substances — like narcotics and testosterone — sometimes need to be written on special paper.

5.  Patients may switch insurance plans more than once a year.

6.  Insurance plans may switch mail order pharmacies during a given year.

With electronic prescribing, the frustration levels and ultimate waste of time involved with paper prescriptions is shrunk down to a minimum.  Not that this is perfect, but it’s far superior to paper.  Patients can still give you wrong information.  The scrips can be mismanaged (lost or incorrectly filled) by pharmacy technicians.  The list goes on…  Once I actually had a technician call me for clarification on a scrip that had nothing wrong with it whatsoever.  She needed to know if I wanted the patient to take 2 tablets a day, or 11.  I went to bed that night comforted that we had such detail-oriented professionals running the pharmacies of America.

Overall though, I would have to say that ePrescribing is a lot like having a bowel movement.  Ninety-five percent of the time it works perfectly and saves me an enormous amount of time and effort in getting me to where I need to go next.  Five percent of the time, it ends in a colossal failure and a lot of extra time sitting around waiting for the ordeal to end.