Healthcare IT

Keep yourself updated on healthcare news regarding practices and medical software. The new regulations and trends in the health industry and all that you need to know.


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Back to 90 days: The big Meaningful Use announcement

The Announcement:

Healthcare providers across the country breathed a collective sigh of relief when The Centers for Medicare & Medicaid Services (CMS) announced its plan to implement a new rule which would shorten the 2015 Meaningful Use reporting period from 365 to just 90 days.

The federal agency’s Chief Medical Officer (CMO) Patrick Conway, M.D. made this announcement via a blog post on January 29.

“The new rule, expected this spring, would be intended to be responsive to provider concerns about software implementation, information exchange readiness, and other related concerns in 2015,” he said, adding that “It would also be intended to propose changes reflective of developments in the industry and progress toward program goals achieved since the program began in 2011.”

Meaningful-Use  CureMD

The list of proposals being considered by CMS:

  • Realigning hospital EHR reporting periods to the calendar year. Consequently, eligible hospitals will have much-needed time to conveniently amalgamate the 2014-Edition software with their workflows. They would also be assisted in adapting to other quality programs which have similar requirements.
  • Adjust other MU specifics so that they are aligned with the long-term goals of the program, and to decrease the complexity and reporting burden faced by providers.
  • Shortening the 365-day reporting period for EHRs in 2015 would aide in accommodating these changes.

The distinction:

However, it is pertinent to mention that the forthcoming proposed rule for MU Stage 3 is unrelated to this announcement; and will go on as planned. The proposal for Stage 3 will be applicable for the Meaningful Use of EHRs from 2017 onwards.

The history:

Many stakeholders in the health care industry had united in opposition of the 365-day MU reporting period for 2015.  The pressure groups were able to persuade several members of the Congress to push for legislation to reduce the reporting period to 90 days.

In response to the final rule published by CMS and the Office of National Coordinator for Health IT (ONC) last August, Congresswoman Renee Elmers drafted the Flex-IT bill in the September of 2014.

The aim of this legislation was for providers to continue 90-day EHR reporting for receiving Meaningful Use incentive payments. However, the last legislative session came to an end before anything significant could materialize.

The bill was re-introduced on January 12, 2015, and College of Healthcare Information Management Executives (CHIME), the American Hospital Association, the American Medical Association, and other large healthcare groups supported its reintroduction.

The reasons:

Pressure to reduce the reporting period had been piling on the CMS for quite some time. More and more care providers and stakeholders were uniting to see this done, stating that the requirements were too stringent to be met.

As mentioned above, this pushed for the matter to be debated in Congress. Additionally, when the stats for Meaningful Use of EHRs came out, the adoption rates for Stage 2 were significantly lower than those of Stage 1.

My views are that the CMS must have already been under immense pressure, and looking to amend the rule, when Congresswoman Elemers reintroduced the bill in Congress. This seems to be the icing on the cake, and could have prompted CMS to finally make the crucial decision.

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Redefine your ICD-10 Costs to implement them on time

The most important reason that makes physicians reluctant to implement ICD-10 is the entire cost of conversion perceived by many in the healthcare industry. A study published in the Journal of AHIMA (JOA) has tried to counter the fears evoked by past researches that gave huge ICD-10 implementation costs.

ICD 10 Guide

The new study puts the price of ICD-10 conversion for small practices from $1,960 to $5,900. Let’s see what parameters were applied for JOA research to identify the range of ICD-10 implementation cost for small medical practices.

ICD-10 Training of practice staff

The research set strict number of hours for training of the medical and non-medical staff of the practice. The cost of 32 hours of training for each practice staff member and three hours for the physician was capped at $3,100. Another $600 was set for buying the two ICD-10 code books.

The cost estimated included the following aspects of ICD-10 training:

  • Education of entire medical practice staff about ICD-10 code sets and tools of implementation.
  • Awareness and training of the actual codes, covering the practice specialty.
  • In-depth training sessions on comprehensive diagnostic and procedural ICD-10 codes.
  • Special training sessions on dealing with specialty codes.

Given the number of staff in a small practice; the cost of training can also go down further.

Updating EHR systems

The estimated cost for software update for ICD-10 given in the JOA research is zero. This is a surprise for those physicians whose vendors are asking for a good amount of money for the updates. As quoted in the study, “Many vendors are including the ICD-10 software update as part of their routine annual software update at no addition cost resulting in physician offices having no incremental ICD-10 related costs associated with their billing, Practice Management and EMR software.”

Depending on your vendor contract, this is a considerable sum of money that you wouldn’t have to pay for ICD-10 conversion. However, if you are among the less lucky ones, then it’s time to replace your EHR vendor.

A word of advice

Being a small medical practice, you don’t have a huge budget that will allow you to experiment around. Therefore, the best possible option is to outsource your billing to a professional billing company. This way you will save your cost of staff training and software updates or replacements.

Download your free ICD 10 Guide and jump start your ICD 10 training now!


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Telemedicine and EHR: Changing the shape of Primary Care in rural areas

Primary care physicians are rapidly adopting the growing field of telemedicine to provide timely care to their patients. Coupled with primary care Electronic Health Records (EHRs), telemedicine enables physicians to defy place and time boundaries to assist patients with quality care.

This trend is gradually picking up pace among primary care practitioners in rural areas to help people who live wide distances apart. Through telemedicine, physicians can provide remote medical care to the patients who are in need of physician advice for non-emergency purposes.

Primary Care EHR

Some primary care physicians are hesitant to adopt telemedicine, fearing this approach may replace them physically and will have a devastating impact on their practice. Telemedicine physicians have proved them wrong.

Primary care physicians have been helping their patients with medical advice on the telephone for a long time. As time progressed, communication has become more face-to-face, using video conferencing which strengthens patient-physician relationship.

This form of healthcare has been most beneficial for mental health patients who are reluctant to be seen at the physician’s practice, which is still considered a stigma in rural areas. Diabetics, hypertension patients and others who need a prescription refill can connect with their primary physicians via technology.

This approach is particularly helpful for physicians who do not have to stay long hours in the clinic. With patient records available on their EHRs, they can advise their patients from comfort of their home. Moreover, if they are using a Cloud-based Primary Care EHR, then all you need is a working internet connection to access patient records.

Jonathan Linkous, chief executive officer of the American Telemedicine Association rightly said, “What’s different is the change in technology and access to broadband that makes it more widely available to doctors and patients.”


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Dangers of Copy/Pasting While Using EHR

American Health Information Management Association (AHIMA) published a report that said 80%-90% of physicians use the function of copy & paste, while 20%-78% create notes from copied texts. It is not a surprise that physicians are making lot of mistakes while making notes in their Electronic Health Records (EHR) because of this practice.

EHRs

Risks of copy & pasting in EHR

Physicians usually copy/paste the previous visit’s treatment plan as a follow-up. This may be dangerous to the patient’s condition in an intensive care unit (ICU), where minor incorrect information may cost their life.

Copying previous data in a hurry will put the patient in fatal risk, as the charts are not up-to-date with new details of the patient’s condition.

This is not only a risk for the patient, but may also be problematic for your Revenue Cycle. Let’s say physician copies patient clinical details from previous visit in the new chart and sends the details to billing department. The billing staff may create a duplicate claim, which is going to be declined by the insurance provider. In case if the claim is processed, then the physician will have to bear penalty during the audit.

Copy and paste issue in Electronic Health Records (EHRs) is a huge concern among healthcare professionals. Director of AHIMA, Diane Warner highlighted this issue while speaking at the MGMA event in 2013. Warner said that large number of medical errors had been the result of copy/paste function in EHRs. Also, physicians would bill inappropriately for the services they never provided.

She added that most of the physicians are using this function without the purpose of committing fraud by duplicate billing, but their unawareness has landed them in great troubles.

However, copy/paste is not a risk in every template. Physicians can use this function to copy demographics, some long standing histories and allergies, and regular medications.

But the best practice of data recording is to take down information on every visit of the patient, or inquire if there has been any change in previous demographic details of the patients. This way, the physician will avoid the possibility of any fatal mishap or audit fraud.

Dr. Olga Leonardi – CureMD Success Stories from CureMD


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Oncology specific EHR improves patient care

Electronic Health Records (EHRs) have been designed to drive more productivity at practices, while improving healthcare of patients. For a specialty practice, it is recommended that they adopt an EHR which is specific to their practice needs and workflow. Same goes for Oncology.

Oncologists have the option to adopt an Oncology EHR that can be purchased from the market after some careful research. Some vendors offer Oncology specific modules that can be integrated into a general EHR to make it practice specific. Others offer EHRs that have been specifically designed and developed for Oncologists from the scratch.

Oncology patients require complex treatments that stretch over a long period of time, resulting in extensive data recording and management. Generic EHRs do not offer Oncology specific modules to assist physicians to identify symptoms, apply procedures and treatment of the patients.

Some useful features

A suitable EHR for Oncologists should offer features that are integral to patients’ diagnosis and treatment, such as:

  • Calculation and administration of drug dosage during chemotherapy
  • Specific charts and diagrams to assist physician in diagnosis
  • Manage and follow-up clinical trials
  • Oncology specific provider note templates
  • Comprehensive library
  • Integrated charge capture for billing
  • E-Prescribing

How Oncologists benefit?

Specialty EHR acts as a support system for Oncologists that enables them to create most detailed medical record that result in timely and accurate diagnosis and treatment of patients. Oncologists can remain updated with patients’ conditions and modify medication and cancer treatment accordingly.

Specialty EHRs support Oncologists gives complete access to patients’ past and current medical records and library that prompts a timely calculation of the patient’s stage of cancer, as mentioned in the American Joint Committee of Cancer’s staging criteria (AJCC).

Some of the other benefits include the interoperability functionality that is extremely helpful to Oncologists. Most of the cancer patients have more than one physicians providing them treatment simultaneously. This is necessary for each physician to be aware of the medication and treatment provided to the patient, so that there is no clash that may be fatal for the patient.