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Top 100 Healthcare IT Companies by Revenue

June 27, 2011 By Leave a Comment

From the EMR Thoughts blog comes an exhaustive list of the top 100 healthcare IT companies by revenue.

Here I have listed the top 25:

  1. McKesson Technology Solutions
  2. Dell Inc.
  3. CareFusion
  4. Philips Healthcare
  5. Cerner Corporation
  6. Siemens Healthcare
  7. Keane, an NTT DATA Company
  8. CSC
  9. Pulse Systems, Inc., division of Cegedim
  10. Cognizant
  11. Emdeon
  12. Epic Systems Corporation
  13. Allscripts Healthcare Solutions, Inc.
  14. EMC Corp.
  15. Wolters Kluwer Health
  16. The Trizetto Group
  17. OptumInsight (formerly Ingenix)
  18. Medical Information Technology, Inc. (MEDITECH)
  19. Nuance Communications, Inc.
  20. 3M Health Information Systems
  21. GE Healthcare
  22. IBM
  23. Microsoft
  24. Oracle Corporation
  25. MedQuist Holdings Inc.

 

Top Three Annoying Things EHR Vendors Do To Sell

June 24, 2011 By Leave a Comment

From the blog EMR and EHR comes this list of top three annoying things EHR vendors do to sell their software:

  1. Can’t explain how their product actually solves physician problems
  2. Claim their product is a Swiss Army knife
  3. Slack off on support after the sale

To this I would also add: leading practices to believe that the system handles all Meaningful Use functions automatically, implying that the system is ready to use out-of-the-box with little or no customization, and leaving smaller practices in the lurch when it comes to both hardware purchases and EMR implementation.

Did we leave anything else out?

 

Medical Practice Trends Podcast 14: Getting the Most Out of Your Medical Software

June 23, 2011 By Leave a Comment


MPT Podcast 14 – Getting the Most Out of Your Medical Software, with guest Mary Pat Whaley of ManageMyPractice.com

This Issue:

  • We only use 10% of the features of most software
  • If you don’t push training, no one will get any better
  • Some basic principles apply to most software

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HIPAA Violations Aren’t in the Cloud

June 22, 2011 By Leave a Comment

From our partners at Software Advice comes this nice summary of the recent history of HIPAA violations and breaches. Physicians looking at EMR systems are concerned about the the security of patient records, particularly those systems that reside on the ‘cloud’ – basically, this is when the data is stored remotely from where the practice or hospital is.

But as Michael Koploy points out, the recent well-documented instances of HIPAA violations were due to security breaches involving stolen computers or hard drives, or employee misconduct, not anarchists hacking into medical databases.

The truth is that security breaches involving paper charts are much easier and more likely than electronic breaches (imagine the cleaning staff walking into your unsecured paper records room). This is why it’s safer to use a debit card at the supermarket – it is much easier for someone to rip you off using the information printed on your paper check. It just so happens that the emergence of electronic medical records systems is coinciding with tougher new regulations that have more of a ‘bite’ than previous legislation.

So, most cases of breaches have more to do with people you know than someone anonymous. And with a little proper planning and continual training of staff, your practice can hopefully keep its name off the HHS wall of shame.

Should Canadian Physicians Be Forced to Use EMR?

June 6, 2011 By Leave a Comment

Could Canadian physicians lose their jobs if they don’t go paperless? In an article in the Canadian Medical Association Journal, a leading health administrator, speaking at an e-Health conference in Toronto, proposed that physicians in Canada face stiff penalties, including firing, if they do not adopt the use of electronic medical records systems.

According to Tom Closson, president and CEO of the Ontario Hospital Association and a member of the board of director of Canada Health Infoway:

Paying physicians who do not use EMRs is an “unfair and inappropriate use of public money,” adding that the system cannot simply afford to wait for change in the form of the retirement of a generation of doctors.

Not surprisingly, Canadian physicians were not too pleased with his position. Dr. Chris Hayes, medical officer for the Canadian Patient Safety Institute, said that health IT is “no holy grail” and that change should be accomplished through professional development initiatives, not through bureaucratic fiat. “It’s not physicians versus the administration.”

How to Qualify for Meaningful Use Incentives – Part 2

May 26, 2011 By Leave a Comment

In part 1, we discussed some of the nuances of registering for Meaningful Use (MU) reporting and why most practices would be better off waiting until 2012 – such as still being able to qualify for E-Prescribing incentives. In part 2, we give you an action plan for getting your practice ready for MU.

How is the MU Reporting Actually Done?

For 2011, practices could merely report they are using EHR in a Meaningful Use without actually sending anything to CMS – this is known as attestation. For 2012, attestation alone is insufficient. CMS will require practices to report on their meaningful use criteria, which for most practices will be a total of 20 (all 15 Core Set and 5 out of the 10 Menu Set items). Some items in the Core Set only need to have functionality enabled (such as Exchanging Critical Information) or performed at least once (Security Risk Analysis). Others will become a daily part of a practice’s workflow (such as Smoking Status or Demographics) and must meet a certain threshold (such as 50% of the number of unique patients seen for the year), unless they are not appropriate for a physician in a particular specialty. For example, an ophthalmology practice does not routinely check vital signs so would report a denominator of zero for that criterion. For a list of the Core and Menu Set objectives see EHR Incentive Programs

Many certified EHR systems will have a means to upload the report files to CMS, either directly or using report-generating software such as Crystal Reports, while other practices may use a third party solution such as registries, the same ones that were helping physicians report PQRI. But while Stage 1 may consist of simply requiring a practice to report on a specific criterion, Stage 2 may contain additional requirements and higher thresholds.

An example of this would be providing a Clinical Summary Report for a patient: In Stage 1, you can document the patient’s preferred format but do not necessarily need to supply it to them in that format, whereas in Stage 2, you might have to comply with that request. And this can make the reporting process that much more onerous.

Advice from a Practice Ready for MU

Sandra Regenye, Director of Billing for Horizon Eye Care in NJ, has these recommendations for getting a start on Meaningful Use:

  • Make sure you are using a certified EHR (EMR) system (click here for a list of ONC-certified EMR systems).
  • Make sure you have a solid understanding of the MU requirements.
  • Do your homework. Don’t count on any one resource to base your plan on. Check your EMR vendor’s resources, CMS, or OMB, for example, for webinars, podcasts, and white papers.
  • Go through all of the measures to see which ones apply specifically to your practice. For example, vital signs would not be an appropriate measurement for an ophthalmology practice, so the denominator for reporting purposes would be zero.
  • Take a look at your workflow processes and see how they are potentially impacted by the collection of data for the requirements. An example would be the preferred language of the patient – when is it collected, by whom, where is the information stored, and is it a required field in your system (it should be).
  • Then check your EMR templates to see where this information is entered and stored. It may not be where you need it, when you need it.

Getting Ready for the Reporting Process

For this year, the first year of Meaningful Use, practices are only required to attest to the fact that they are meeting the MU requirements. Attestation means you are collecting the data in some fashion, even if you are only doing it manually, as on a spreadsheet. For 2012, practices will need to actually collect and submit the data to CMS. The attestation process officially began on April 18, 2011. CMS offers webinars and updates with specific details. Ms. Regenye says these have not been real clear, “but they are getting better.” She recommends that all practices register with Medicare now, even if they don’t have an EMR system yet.

Medical Practice Trends Podcast 10: EMR and the Marketability of Your Practice

May 24, 2011 By Leave a Comment


MPT Podcast 10 – EMR and the Marketability of Your Medical Practice, with guest Mike Meikle, Hawkthorne Group.

This Issue:

  • Besides financial incentives for implementation, EMR may offer some marketing benefits
  • Patients may perceive a practice without EMR as not being “cutting edge”
  • Far from being impersonal, EMR in the practice may actually be more humanizing

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Medical Practice Trends Podcast 9: The Challenges of Integrating a New Technology into the Medical Practice

May 17, 2011 By 1 Comment


MPT Podcast 9 – The Challenges of Integrating a New Technology into the Medical Practice, with guest Chris Mertens, VP of the Personal Systems Group for Hewlett-Packard.

This Issue:

  • Why healthcare providers are skeptical of implementing EHR despite its reported benefits
  • What are some other concerns physicians have, such as cost or loss of productivity?
  • What are some issues related to the quality of patient care?

 

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How to Qualify for Meaningful Use Incentives – Part 1

May 12, 2011 By 3 Comments

Like many things in life, you can either choose to do something or wait until something happens to you. Many physicians are taking the latter approach when it comes to electronic medical records implementation and the Meaningful Use (MU) incentives from CMS. Their feeling is that it would be safer to wait until EMR systems are perfected (which they never will be), to wait until the government certifies a particular EMR system (which they never will do), and until the MU requirements are 100% unambiguous (dream on). These things may never come to pass.  And after 2012, the MU incentives will start to decrease and then reimbursement penalties will kick in.

Meaningful Use: What’s the Point?

In his 2004 State of the Union address, President George W. Bush outlined his plan for the adoption of electronic health records that could be accessed by all citizens in the United States. The Department of Health and Human Services (HHS) then created a 10-year map to implement that plan, although there was no specific funding set. Then in 2009, as part of the American Recovery and Reinvestment Act of 2009, the HITECH Act (Health Information Technology in Economic and Clinical Health) allocated almost $30 billion to push the adoption of EHR through the use of financial incentives. Subsequently, rules were created that required those providers seeking incentives to prove they were using certified electronic health records technology according to a set of guidelines of quality healthcare, or in a ‘meaningful use’ manner.

Non-MU Incentives Aren’t Too Shabby Either (or Why Waiting Until 2012 May Be More Profitable)

In the case of our practice, we had transitioned our old practice management (EPM) system to a new one with an integrated EMR a few years ago, but felt it prudent to wait a bit before we attempted to implement the EMR module. That came about at the end of 2008, so now that we have about 2 ½ years of ‘live’ experience with EMR, we are turning our attention to the MU incentives. But we haven’t been idly sitting by. Using software we developed in-house, we have been qualifying for both PQRI (Physician Quality Reporting Initiative) and E-Rx (E-Prescribing) incentives since their inception, in 2007 and 2009 respectively. Those have resulted in as much as a 4% bonus of our annual Medicare fees.

Although Stage 1 of Meaningful Use officially begins 2011 – with Stages 2 and 3 slated for 2013 (for the time being) and 2015, respectively – we decided that we would wait until 2012 before seeking the Meaningful Use (MU) incentives. The Office of the National Coordinator on Healthcare IT (ONC) announced that practices can qualify for the full MU incentives starting either in 2011 or 2012. They also ruled that practices can also get PQRI incentives concurrently with the MU incentives. So why would we wait another year? ONC also ruled that MU would disqualify ERx incentives, so this would give us another year of E-Prescribing bonuses plus another year to get our practice ready for MU. This means, however, that we have only one year to prepare for Stage 2 in 2013 instead of two, but this mostly builds on the work that needs to be done for Stage 1. (And, did I mention this means more money?)

Some Practices are Ahead of the Curve

Horizon Eye Care is an eight-doctor ophthalmology practice in Margate, New Jersey. Like our practice, they use an integrated EMR/EPM system from NextGen, but they have been using the EMR module for the past 10 years. According to Sandra Regenye, Director of Billing, they were ready to qualify for MU this year, but also decided to wait until 2012, since there was no decrease in the total incentives for waiting. And in addition to being able to collect ERx incentives for 2011 (which are excluded under MU), this is allowing their practice to perform simulations to test run the reporting process.

Ms. Regenye points out that it is the practice that must be a meaningful user of EMR, not the EMR system itself. “If you are not using your EMR in an appropriate manner, then you are not a ‘meaningful user.’ Even the best, certified EMR system cannot magically qualify you for MU incentives. There is no ‘plug-and-play’ for meaningful use. “

In part 2, we’ll map out your Meaningful Use incentives action plan.

Medical Practice Trends Podcast 8: Recent Changes in the Enforcement of the HITECH Act

May 10, 2011 By 1 Comment


MPT Podcast 8 – Recent Changes in the Enforcement of the HITECH Act and the Impact on Your Practice, With Guest Mike Meikle, Hawkthorne Group.

This Issue:

  • Possible civil and criminal penalties a medical practice can face
  • What do the new HITECH Act provisions mean to your medical practice?
  • What are potential penalties for violating the HIPAA regulations?
  • What proactive measures can you take to protect yourself and your practice?

 

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