Meaningful Use Articles - Medical Practice Trends

Bonus Resource – The Techie’s Guide to EHR Implementation

September 1, 2010 By Peter Polack 1 Comment

For those of you tasked with the actual implementation of electronic medical records in your practice or business – CIO, Director of IT, Administrator – here is a nice guide to EHR implementation courtesy of CHIME (College of Healthcare Information Management Executives).

CLICK HERE to download the PDF

Although it does present the topic from a technical perspective, it does also cover issues important to the CIO or Director of IT such as assessing the financial incentives weighed against implementation costs and a discussion about the importance of the ‘people factor’ as I have previously discussed: (see How to Prepare Your Team for EMR Implementation and The Right People for Your EMR Implementation)

E-Book PDF: Download (1.0MB)

Overview of the Meaningful Use Final Rule

August 31, 2010 By Peter Polack 2 Comments

From the folks of AHIMA (American Health Information Management Association) comes a nice and concise overview of the final rule of the Meaningful Use provisions for electronic medical records implementation. AHIMA is one of the largest associations of health information management (HIM) professionals and was founded in 1928 – which I am pretty sure pre-dates the use of electronic medical records.

This first in a series of white papers offers a basic description of the final rules. We covered some of the specifics in previous posts CMS Final Rule Part 1, Part 2, and Part 3.

But if you are new to all of this and just want to get your feet wet, here is a good place to start:

CLICK HERE to download the PDF

E-Book PDF: Download (154.1KB)

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?

CMS to Publish "Meaningful Use" Final Rule by July 14

July 2, 2010 By Peter Polack 1 Comment

According to a report on FierceEMR.com, the CMS has announced that by July 14 it will release its final ruling on the EMR “meaningful use” standards which will finally spell out just how healthcare providers can become eligible for the HITECH (Healthcare Information for Electronic and Clinical Health) Act financial incentive payments.

In addition, it will presumably unveil its plan for aligning its Physician Quality Reporting Initiative (PQRI) with the EMR financial incentives program.

“We propose to include many ARRA core clinical quality measures in the PQRI program, to demonstrate meaningful use of EHR and quality of care furnished to individuals,” CMS states in an advanced copy of the proposed reg, CMIO magazine reports. “We propose the selection of these measures to meet the requirements of planning the integration of PQRI and EHR reporting.”

Bonus Resource: How to Qualify for EMR Stimulus Funds

July 1, 2010 By Peter Polack 3 Comments

One of the most common questions we get is, “How to we qualify for the financial incentives for EMR implementation?” Even so, we would think this should be everyone’s number one question. After all, the costs of both the EMR software and the associated hardware are not insignificant. Who is going to pay for all of that? You are.

But what if the government gave you a nice, fat check for your efforts? Say, about $44,000 per provider over the next five years?

Ah, but there is a catch. Or, several catches to be exact. These fall under the area of what is known as “meaningful use“. In order to qualify for these funds, a provider must be able to show he or she has met certain goals or objectives.

Medical Practice Trends has partnered with the folks at SoftwareAdvice.com to give you a guide on How to Qualify for EMR/EHR Stimulus Funds.

Click Here for more information

Study: Current EMRs not good for care coordination

January 7, 2010 By Frank Polack Leave a Comment

One of the goals of meaningful use and all the related federal spending of health IT is for EMRs to improve care coordination. But the current reimbursement system that’s heavy on fee-for-service encourages software developers and users alike to focus on documentation of billable events rather than coordination of care, a new study finds.

CMS Releases Proposed Meaningful Use Criteria

December 30, 2009 By Peter Polack Leave a Comment

The Centers for Medicare and Medicaid Services (CMS) announced today a proposed outline for Meaningful Use criteria, in accordance with EMR implementation provisions under the Health Information Technology for Clinical and Economic Health (HITECH) Act, part of the American Recovery and Reinvestment Act (ARRA) of 2009. These specify some of the guidelines by which physicians can receive incentives of up to $44,000 per provider, over 5 years, beginning as early as 2011.

Stage 1 criteria (the first of 3 total) would cover 25 meaningful use objectives (and 23 for hospitals). These are listed under modules known as Health Outcomes Policy Priorities such as Improving quality and patient safety (use of drug-allergy interaction checks, use of ePrescribing, maintaining active medication list, etc.), Engaging patients and their families in their health care (e.g., provide patients with a copy of their health information), Improving care coordination (e.g., exchanging key clinical information among authorized entities), Improving population and public health (e.g., capability to submit data to immunization registries), and Ensuring adequate privacy and security for personal health information (through the use of appropriate EMR technology).

The implementation of Stage 1 meaningful use standards would begin in 2011. Stage 2 (which would essentially expand upon certain aspects of Stage 1) and Stage 3 (which would deal with achieving improvements in conditions of a national high-priority nature and population health outcomes) would follow later.

While this certainly doesn’t clear things up completely for the individual physician, every piece of information that trickles down from Washington is eventually analyzed and translated for all parties which have a vested interest in the process. Hopefully, resources such as this can help doctors stay informed and as up-to-date as possible.

If you have any comments or questions, please post them here. If we don’t know the answer we’ll certainly try to find someone who does.

The Meaning of Meaningful Use of EMR

October 27, 2009 By Peter Polack 4 Comments

If you talk to anyone who is involved in the electronic medical records (EMR) industry, one of the biggest points of discussion is what is known as “Meaningful Use of EMR.” What started as a well-intentioned (by some) effort to establish standards for EMR software systems has morphed into political jockeying by corporations, consumer watchdogs, and others.

The US Dept of Health and Human Services (HHS) outlined these criteria for Meaningful Use of EMR:
1)   Improve quality, safety, efficiency, and reduce health disparities
2)   Engage patients and families
3)   Improve care coordination
4)   Improve population and public health
5)   Ensure adequate privacy and security protections for personal health information

And although each of these has defined goals followed by specific objectives and measures for the years 2011, 2013, and 2015, these still sound a bit ambiguous. Many industry experts, however, expect these to be more fine-tuned as the dates approach, but medical practices will have to stay informed to keep ahead of the curve.

Financial Incentives

As part of the ARRA (American Recovery and Reinvestment Act of 2009), financial incentives will be given to those physicians whose practices demonstrate “meaningful use” beginning January, 2011.

The incentive payment, according to CMS, is equal to 75% of Medicare-allowable charges for covered services in a given year, and maxes out as follows:

Year 1 – $15,000
Year 2 – $12,000
Year 3 – $8,000
Year 4 – $4,000
Year 5 – $2,000

For those practices who are early adopters of the technology and hit the threshold for meaningful use in 2011 or 2012, the first year payment would be $18,000. Note that this only applies to Medicare; there are additional incentives for healthcare providers who have a certain threshold of Medicaid patients and/or who practice in a rural area. The threshold for office-based pediatricians is lower, and so they would be more likely to qualify for those additional funds.

SoftwareAdvice

[table courtesy of SoftwareAdvice.com]

Even considering the fact that EMR implementation may cost anywhere from $10,000 to $50,000 per provider, these incentives would certainly make that investment more palatable.

Those practices that procrastinate, however, will be penalized with cuts in Medicare and Medicaid payments:

2015 – 1%
2016 – 2%
2017 – 3%
2020 – 5% (maximum reduction)

So, how do you know if you qualify? According to the health IT blog NetDoc, to be a “meaningful EHR user”, a physician must satisfy three criteria:

Must use “certified EHR [EMR] technology”
Must demonstrate that the certified EHR technology is connected in such a way that it provides for the electronic exchange of health information to improve the quality of health care, such as promoting the coordination of care (using HL7 or XML standards)
Must submit information on clinical quality measures specified by HHS (such as PQRI)

Some physicians have told me that because there isn’t a final definition of what is considered “certified EHR technology” they are just going to wait. Big mistake. Most health care IT experts working on and advising on this issue feel fairly strongly that the Office of the National Coordinator for Health Information Technology (ONCHIT) will set CCHIT (Certification Commission for Health Information Technology) criteria as the standard for EMR certification.

CCHIT is a non-profit organization funded by various corporations and groups such as the American College of Physicians and the American Academy of Family Physicians, and was recognized by the US Dept of Health and Human Services (HHS) as a certifying body in 2006.

Some critics, however, charge that CCHIT is a shill for the Healthcare Information and Management Systems Society (HIMSS), the healthcare industry’s membership organization focused on healthcare IT. Although made up of both corporate and individual members, these critics feel that their goal is to corner the market for certain major EMR players. Nevertheless, unless or until there is an alternative, most EMR vendors are using CCHIT certification as the benchmark.

In addition to the EMR certification criteria, the ONCHIT is expected to adopt an initial set of standards and implementation specifications by the end of the year 2009.

Timeline

So, is too late to implement EMR in your practice and still qualify for the financial incentives? Well, that depends on the size of your practice, type of specialty, and how motivated your doctors and staff are to go paperless. Just don’t expect to run down to Office Depot, buy an EMR program and launch it the next day (although there is talk about WalMart getting into the EMR business, but we’ll leave that story for another day…)

According to MBA HealthGroup, these are some reasonable time frames to expect for EMR Implementation:

Stage 1 – up to 6 months – researching vendors, getting buy-in, setting up an EMR committee, checking out demos, and making a final decision on the EMR system
Stage 2 – up to 5 months – time it will take to actually ‘go live’. In the meantime, adapting workflow to EMR system you chose, ordering hardware, and standardizing processes
Stage 3 – between 6 and 12 months – amount of time it will likely take to achieve “meaningful use”, which includes ePrescribing, documenting electronically, and ability to report certain items (which are still being determined)

MBA HealthBlog

[timeline courtesy of MBA HealthBlog]

Smaller groups and solo doctors may be able to purchase a more basic, “out-of-the-box” EMR system and more quickly adapt their workflow to the system, rather than vice versa in the case of larger medical practices. But, the one thing you can count on with EMR implementation is that you can’t count on anything – that is why some sort of timeline is important [see EMR Implementation Rollout].

What this boils down to is that those practices that have already started implementing EMR will have a good shot at getting those higher financial incentives. On the other hand, physicians who have been wishing that the whole idea of EMR was just a fleeting fad may not only miss out on these incentives but may also face cuts in their reimbursement.

Questions? Comments? Post them below

Putting Meaningful Use in Your Practice

July 20, 2009 By Peter Polack 2 Comments

A recent article in the AMA news discussed some of the continued ambiguities of the “Meaningful Use” prerequisites handed down by the Health IT Policy Committee. Nevertheless, it does give everyone an idea of where they are headed. Generally speaking, meaningful users are defined as healthcare-providers who are using E-Prescribing, that their EMR technology is connected in such a way that there is an electronic exchange of health information, and that clinical quality measures are submitted to the government via electronic means.

For practices that fail to have meaningful use by the end of the set timelines, not only would there not be incentives, there would actually be penalties in the form of reductions in Medicare reimbursements – unless the practice could demonstrate some type of financial hardship that would prevent adoption of EMR.

If you don’t think the financial incentives are worthwhile, thing again. SoftwareAdvice.com has a nice explanation of what medical practices have to gain by getting the ball rolling and not waiting until the perfect EMR solution falls out of the sky and hits them in the heads (note: it ain’t gonna happen).

To give you an idea of the timeline we are talking about, here is a graphic from a committee report (courtesy of Digitized Medicine). So, what are you waiting for?

meaningful-use