Electronic Medical Records Articles - Medical Practice Trends

Hospitals Wooing Doctors with EMR

August 26, 2010 By Peter Polack 2 Comments

A report from American Medical News reports that hospitals are increasingly courting local physicians with free or subsidized EMR systems. Why?

A recent report by the American Hospital Assn. on the effects of the recession found that 72% of hospitals reported a decline in the number of elective procedures, and 70% reported a drop in patient volume from 2009.

A major criterion of meaningful use is proving the ability to communicate and share health information electronically. For hospitals, this means demonstrating that they are sharing this information with physicians. And the quickest way to achieve that is to help doctors get up-to-speed with EMR. Experts say that this also a good way for hospitals to strengthen relationships with the very physicians they count on for referrals.

Other experts urge caution on the part of medical practices. Hire a consultant and make sure the potential system fits in with your overall EMR implementation strategy. As J. Ryan Williams, a healthcare attorney from Cleveland points out:

You could be in a position of accepting the donated technology, share in that cost, then one, two or three years down the road that technology, God forbid, doesn’t allow you to meet your meaningful use criteria. [Then] what good have you done?

Eligibility for EMR Incentives Could Be Widened

August 23, 2010 By Peter Polack 1 Comment

The AMA reports that new legislation is proposing to extend the eligibility for EMR incentives to include licensed psychologists and clinical social workers.

The Health Information Technology Extension for Behavioral Health Services Act also would expand the Medicare hospital incentive to include inpatient psychiatric hospitals, and extend Medicaid hospital bonuses to community health centers, mental health treatment facilities, psychiatric hospitals, and substance abuse treatment facilities. The bill was introduced on Aug. 5 by Sen. Sheldon Whitehouse (D, R.I.), and a companion bill was introduced in the House by Rep. Patrick Kennedy (D, R.I.).

Whitehouse said his legislation “will give mental health professionals access to comprehensive and up-to-date medical histories, enhancing the precision of diagnoses and reducing medication errors.”

Pros & Cons of Server-Based EMR Systems

August 20, 2010 By Peter Polack 2 Comments

Do EMRs Make Practicing Medicine Safer or More Dangerous?

August 13, 2010 By Peter Polack 3 Comments

Recently I wrote about a Harvard study that found evidence that physicians that use electronic medical records systems (EMRs) are less likely to be involved in a malpractice lawsuit. But regardless of whether your charts are better documented and therefore make you less of a target for a claim, does using EMR make you practice medicine better?

According to the Huffington Post Investigative Fund, there have been several cases of EMRs gone amok. In most cases there was no harm to patients. But they quote Dr. Jeffrey Shuren of the FDA as attributing six deaths and 200 injuries to poorly implemented CPOE (computerized physician order entry). Many critics of the government’s EMR implementation plan point to these cases as examples of not enough regulation and oversight.

On the other hand, the ONC (Office of the National Coordinator [for Health Information Technology]) spokesman says the they are working closely with a number of organizations including the FDA to improve safety. Critics say that the ONC has too friendly a relationship with the EMR industry, and feel that the FDA needs to be given more authority to collect and analyze errors caused by EMR systems.

Which Doctors Are Most At Risk For Malpractice Lawsuits?

August 12, 2010 By Peter Polack 1 Comment

According to a report by Fierce Healthcare, a survey from the American Medical Association found that 95 out of every 100 physicians will be sued for malpractice sometime in their career.

In addition, their 2007-2008 survey of almost 6,000 physicians across 42 specialties found that:

About 2/3 of doctors aged 55 and older have been sued
Male physicians were twice as likely to be sued as female physicians
General surgeons and OB/GYNs had five times the risk as pediatricians
Doctors in solo or single-specialty groups had a higher risk than those in a multi-specialty group

They also noted that physicians prevailed 90% of the time that cases went to trial, although these cases can still average $100,000 in defense costs. And even the 65% of cases that are dropped or dismissed can cost over $20,00o to defend.

Using EMR Reduces Your Risk of a Malpractice Claim

August 10, 2010 By Peter Polack 4 Comments

According to a study from Harvard University, physicians who use electronic medical records systems may be less likely to be sued.

“When providers use electronic records in the outpatient setting, the likelihood of a paid malpractice settlement was about two-thirds as high,” said one of the lead authors, David Westfall Bates, MD, professor of medicine at Harvard Medical School in Cambridge, MA, and professor of health policy and management at the Harvard School of Public Health.

The study group says their findings “support the hypothesis that EHR adoption and use lead to improved quality of care and patient safety, resulting in fewer adverse events and fewer paid malpractice claims. ” In addition, EHRs may result in more extensive and more legible documentation leading to stronger legal defenses when malpractices lawsuits are filed.

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What is EMR?

August 3, 2010 By Peter Polack 3 Comments

CMS Meaningful Use Rules, Part 3

July 29, 2010 By Peter Polack 3 Comments

In part 1, we discussed just what is meant by a meaningful user and in part 2 we touched briefly on some of the changes made in the meaningful use rules from the proposed rules to the final rules. Whereas initially there was an 80% threshold that had to be met for pretty much every objective, after much discussion and consideration, CMS agreed that for some of these measures that was too high a bar to jump.

Here is a nice summary of the final rules thresholds for each of the meaningful use objectives and measures. Thanks to Robin Raiford, RN, from the HIMSS Legislation and Regulation Review Task Force, for providing us with this great resource.

It’s too detailed to see clearly on the website so….

RIGHT-CLICK HERE to download the PDF file

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CMS Meaningful Use Rules, Part 2

July 22, 2010 By Peter Polack 2 Comments

In part 1, we introduced the different stages of meaningful use criteria as defined by CMS in their final rules, released July 13, 2010. Many practices and hospitals breathed a collective sigh of relief on the one hand, as several criteria had thresholds that were less onerous than were originally proposed. It seems that CMS has been listening.

Thresholds for CPOE and e-Prescribing

For example, as we mentioned earlier, the threshold for meeting criteria for CPOE (computerized physician order entry) is now set at 30%. This means that only 30% of unique patients (not total patient visits) need to have at least one order entered into the electronic medical record system to meet those goals.

Another example is electronically transmitted prescriptions or e-Prescribing. Originally set at 75% of “permissible prescriptions”, this has been dropped to “at least 40%”. This was due in part to objections that (1) some pharmacies are not quite ready to accept e-Prescribing and (2) some patients insist on getting a paper prescription.

Structured Data vs Unstructured Data

Along the subject of prescriptions, an active medication list must be maintained on patients (with the default threshold of at least 80% of unique patients) in the form of “structured data”. Structured data refers to data that can be identified by the EMR system. In other words, [Read more...]

CMS Releases EHR Adoption Rules, Part 1

July 14, 2010 By Peter Polack 2 Comments

On Tuesday July 13, CMS released the final rule for adopting a certified electronic health record (EHR) system.

After listing about 60 acronyms and abbreviations (and it’s impossible to remember them when reading the subsequent text), what follows is approximately 800 pages of proposals, related comments, and final rulings.

All this is to spell out the meaning of meaningful use (which we first touched on in October ), how to be considered an EP (eligible professional) and when said EP can expect to first receive any kind of incentive payment – for the early adopters, the first “payment year” is calendar year (CY) 2011.

When you actually receive the payment could be the end of the following calendar year). Hospitals will typically be incentivized on a fiscal year (FY) basis.

We’ll attempt to digest this compelling tome, one 100-page piece at a time (or so). Keep in mind, though, that this is only what CMS considers “Stage 1″ of the meaningful use criteria. Stage 2 criteria are expected by the end of 2011 and Stage 3 criteria by the end of 2013. The idea is to have an “initial graduated approach to arriving at the ultimate goal”: total enlightenment of EMR, I suppose.

As we previously mentioned, a meaningful user is one who:

[Read more...]