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Archives for: March 2009

03/31/09

Permalink 01:54:35 pm, Categories: EMR Related News, 437 words   English (US)

Health Care Stimulus – Who is eligible?

One major goal of The American Recovery and Reinvestment Act of 2009 is to encourage physicians to adopt Electronic Medical Records (EMRs). The act does that by paying incentives up to $44,000 to physicians that adopt EMRs. In addition, the act penalizes physicians without an EMR by decreasing their Medicare reimbursements.

How can physicians qualify for the incentives and avoid the penalties? According to the legislation, they must be an “eligible professional” who uses a “certified EMR” in a “meaningful way.” In my last article we talked about certified EMR systems. This time we will examine the “eligible professional” requirement.

The “eligible professional” requirement has four main components. First, the “professional” must be a healthcare provider such as a physician, physician’s assistant, or nurse practitioner. Second, the provider must receive Medicare reimbursement payments.
Third, the provider must not work in a hospital-based environment. For example, anesthesiologists, pathologists, and emergency room physicians would not qualify. Hospitals are reimbursed as a corporate entity according to a separate schedule, and not on a per-provider basis. Fourth, labs and skilled nursing facilities are not required to adopt an EMR, so it is possible that providers working at these facilities may not qualify.

One drawback of the stimulus program is that unqualified providers may feel that they do not need an EMR. Good EMR systems offer many benefits – not just money from the government. EMR systems can help a practice cut costs – especially those associated with managing paper charts and outsourced dictation. EMR systems can improve patient care by requiring providers to complete more comprehensive exams and reviews. EMR systems can help increase revenue since providers will no longer have to under-code because their current paper charts do not meet CMS requirements.

Although many things are uncertain at this point, geriatric and long-term care providers that work primarily in nursing homes may not qualify for the program. This does not mean that geriatric or any other physicians should not adopt an EMR. On the contrary, a lean, mobile EMR can greatly benefit any practice, especially geriatric/long term care practices.

Currently unqualified providers should also keep in mind that the stimulus act is still in its infancy and will probably undergo several revisions. Congress may decide that labs, skilled nursing facilities, and similar practices need to adopt an EMR so they can benefit from information sharing and contribute to the goal of universal electronic medical records. Therefore, providers should not delay or cancel their plans to adopt an EMR, rather they should move forward so they have plenty of time to implement their systems and learn to use it in a meaningful way.

03/23/09

Permalink 09:56:33 am, Categories: EMR Related News, 417 words   English (US)

Health Care Stimulus – What is a Certified EMR?

The American Recovery and Reinvestment Act of 2009, otherwise known as the Stimulus Act, authorizes the government to pay incentives totaling $44,000 per physician to encourage the adoption of Electronic Medical Records (EMRs). The incentives are coupled with penalties; physicians that don’t adopt an EMR will be penalized by a reduction in Medicare reimbursements. In order to qualify for the incentives and avoid the penalties, an “eligible professional” must use a “certified EMR” in a “meaningful way.”

The big question on everyone’s mind is “What is a certified EMR?” Physicians currently using EMRs want to be sure their systems are certified. Likewise, physicians shopping for an EMR don’t want to risk purchasing something that won’t meet the stimulus criteria. Unfortunately, the legislation did not specify certification criteria. We will have to wait for congress, various offices, and committees created by the legislation to agree on the requirements.

Right now, many people point to CCHIT as the certification criteria. However, only 8% of EMR vendors were CCHIT-certified in 2008. Does this mean that 92% of all the EMR systems on the market are garbage? Hardly. CCHIT is a hugely expensive endeavor that costs about $40,000 to complete, including registration and maintenance fees. This effectively locks out many smaller vendors that can’t afford to apply. In addition, many of the CCHIT requirements pertain to software with relational databases, or are otherwise unnecessary for a functional EMR system. Finally, CCHIT does not consider things like usability or ability to generate return on investment.

The government has a history of creating EMR standards that have suffered from poor participation. The now-defunct Doctor’s Office Quality – Information Technology (DOQ-IT) program was intended to promote EMR adoption and implement a pay-for-performance program. Since only a few EMR vendors were DOQ-IT certified, and only one vendor was able to submit regular production data, the government scrapped it in favor of PQRI. The Physicians Quality Reporting Initiative (PQRI) program was similar, but with less-stringent requirements. In 2007, only about 10% of physicians successfully received their 1.5% bonus.

Whatever the government decides will constitute a “certified,” EMR system, we can be sure that decision will go through a few revisions. It would not make sense for the government to adopt standards that rule out 92% of the EMR industry. Physicians contemplating an EMR purchase should not wait until the lengthy decision process is over. Purchase and install an EMR system now, that way your practice will have plenty of time to learn your system and use it in a “meaningful way.”

03/09/09

Permalink 01:05:53 pm, Categories: EMR Related News, 253 words   English (US)

2009 AMDA Symposium Review

The 2009 AMDA annual symposium was in Charlotte, North Carolina this year from March 5th to the 8th. XLEMR attended the show on Friday and Saturday. We had a great time meeting geriatric and long term care providers from around the United States. We received a lot of traffic at our booth; We gave so many software demonstrations that we barely had time to catch our breath.

Our product demonstrations in the technology pavilion went well. Both presentations were well attended and, the crowd asked many thoughtful questions. Everyone was impressed with XLEMR’s simplicity, mobility, and efficiency. We are one of the few vendors with a version for geriatric providers that can run on a single computer.

Thursday night we were treated to an old-fashioned southern barbeque courtesy of Dr. James Jewell. Dr. Jewell is a geriatric physician operating in Rock Hill, South Carolina, and a customer of XLEMR. We had a great time. The party was excellent, the food was exquisite, and the people were lots of fun.

We shared a booth with Voice Factor this year. Voice Factor is a voice recognition product that is built on Dragon. It offers enhanced features such as extensive medical vocabularies in addition to outstanding training and support. Voice Factor allows you to dictate quickly and accurately using forms, free text, and custom defined commands. Voice Factor works great with XLEMR.

Please click on the links below to listen to our podcasts, recorded live at AMDA:

Introductory Podcast

Interview with Bill Hampton from Voice Factor

03/02/09

Permalink 03:19:06 pm, Categories: EMR Related News, 319 words   English (US)

An Open Letter to Congress Regarding the Stimulus Act

Dear Senators and Representatives,

I am extremely concerned about the American Recovery and Reinvestment Act of 2009, particularly the sections regarding healthcare. I have three major concerns about the act.

1) Loss of Freedom of Choice
I am worried the act will eliminate our choice to determine our own computer systems and that the CCHIT standard will be required. My personal experience has shown that CCHIT systems are unnecessarily complex and expensive and fail in my colleagues’ practices, while simpler systems tend to function must better. Many physicians lack basic computer skills. They will require extensive training by American labor before any EMR system will be successful.

2) Stimulus of Foreign Programmers
I am also worried our tax dollars will go to large software companies that use foreign labor to develop their Electronic Medical Record (EMR) systems. Please require that only EMR’s produced by Americans in America using American Software will receive any stimulus funding.

3) Loss of Privacy
I am worried the national health records database will jeopardize the privacy and security of my patients’ medical records. Do not force Americans to put their Private Health Information (PHI) on the internet. We do not know where it is; who has access to it; how many copies there are; or how this information will be used. Currently most transcription is done by Indians, who are not obligated to follow HIPAA rules. Please require that no PHI be transmitted outside the US.

Our first step toward PHI Management MUST be with USB Jump Drives. If we can’t make a USB Jump drive work, we’ll never get complex computer networks with security and interoperability issues of cross database integrity working. USB drives allow the patient to have control over their own medical records.

I am a physician operating a practice in Cumming, Georgia, which lies within Georgia’s 9th district.

Sincerely,

Bob G. Lanier, MD
770-205-2220
bob@bobglaniermd.com
8460 Lanier Drive
Cumming GA 30041

XLEMR

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