Healthcare & Technology

More incentives for E-prescribing?

Link: Implementation of the Electronic Prescribing Incentive Program and changes to the Physician Quality Reporting Initiative.

The Centers for Medicare & Medicaid Services (CMS) announced yesterday that they are implementing the new Electronic Prescribing Incentive Program. This incentive program is authorized for providers if they meet requirements beginning January 1, 2009.

Requirements from CMS can be found at the link above.

More info can be found here E-prescribing can earn Docs an extra 5.1 percent.

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Medical groups move to Social Networking?

Link: MGMA launches social networking platform.

Amazing! I never thought I would see the day that physicians and the medical community would move to social networking platforms. This is exciting because the collective knowledge of the community, when shared, can truly help to improve delivery of patient care. Only one question...where do they find the time?

According to William F. Jessee, MD, of the Medical Group Management Association, the proprietary social networking community would provide:

• Discussion groups - members can create ad hoc, event-based or issue-related groups;
• Blogs - members can create their own blogs for other members to read, respond to and rate;
• File repository/resource library - members can upload, download and search documents to share with their peers;
• Expanded subscription options - members can participate online, via e-mail or both; and
• Enhanced member directory and member profiles - members can search for one another by name, location, certification level, membership participation, organization type, practice type, practice setting, specialty, physician count, interest areas and education.

To read more about it, visit Healthcare IT News online.

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Legal Implications for PHRs

Link: The Health Care Blog: Personal health records and the law.

"The Rise of the Personal Health Record: Panacea or Pitfall for Health Information" is an article written by two health care lawyers, Bob Coffield and Jud DeLoss on topics of the changing world of PHRs, introductory material on Health 2.0, and legal and compliance issues for PHRs. Information related to this article will be presented to the Health Information and Technology Practice Group which is a forum that provides education about legal issues arising from the use of technology in health care.

The article discusses fragmentation in the healthcare system, noting that PHRs may be the "disruptive" technology that will address complexity in maintaining and sharing health information. The article also mentions that transformation to a PHR system by facilities and/or providers may be fueled by interest in web-based social networking and Health 2.0. Of course, with each mention of electronic health records, the question of ownership of the information arises. Their discussion suggests that the patient should be in control of his medical information. I believe that is a point well worth noting.

 

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Amazing video about one Vendor's EMR solution - it states reasons to adopt

Link: EMR and HIPPA

I just watched this video that was published, I assume, by Allscripts, a software EHR vendor. It was quite tastefully done in a "Web 2.0" style and provided descriptions of problems with existing paper-based health records and listed benefits for adoption of electronic health records (EHR).

I watched another video from Allscripts last week. I was impressed with their artistic license on that video, but this one is quite good. It is a bit long, but contains these reasons for EHRs and other items of interest for ambulatory practices:

• when you spend too much time looking for patient's charts,
• when you want to know what happened to your patient in the ER 2 days ago,
• when you spend more time on paper than with patients,
• when patients complain about filling out repeated forms,
• when your office staff employs one person who's responsibility is to file charts,
• when you want to identify your patients who are taking a Rx that has been recalled,
• when you want to ensure that records don't get lost,
• when you want to ensure that prescriptions are accurate and complete,

and finally,

• when you want to ensure that coding is accurate so you will get paid and not audited...

Gives those of us in healthcare some food for thought.

 

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Health IT - know where you're going before starting the journey

AHRQ has an Evidence Based Handbook for Nurses  (April, 2008) on their website. The PDF version of the handbook can be downloaded from the site.

While performing a literature review for research on Nurses' working conditions, I came across this handbook that talks about, among other things, the impact of health care information technology on clinical practice workflow. It discussed the benefits of Health IT to improved quality and efficiency of workflows as well as the impact of health IT as an initial disruptive factor to the existing workflow.

This supports my belief that successful adoption of Health IT in the clinical environment will require a change in culture and should begin with a comparison of "how things are done now" - the "AS-IS" to "how we want to do things" - the "TO-BE." It is important to first establish the goal before taking steps to implement any technology solution. Read my discussion of Culture Change for Healthcare EHRs and beyond.

A key concept in the disruption of Health IT is that often the software will "implicitly assume a workflow" in the way that screens and the user interface is organized. The AHRQ report also discusses the need to understand existing workflows of the clinical environment in order to be successful in health IT adoption.

 

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The critical condition of US healthcare? What's next?

POV Critical Condition, a documentary by Roger Weisberg, originally broadcasted on PBS, is available for online viewing in its entirety until November 11, 2008. A synopsis of the film can be found here.

As I watched the beginning chapter of these stories, reflected on the rising cost of healthcare, and the rising numbers of uninsured Americans, I began to think... How will healthcare IT make a difference?

The answer is not entirely clear right now, but, in addition to other national initiatives, one solution may involve reducing the business costs of healthcare and improving efficiencies in the delivery of healthcare.  The appropriate, effective use of IT has reduced operating costs in other industries, why not Healthcare?

Critical Condition is a production of Public Policy Productions Inc. in association with Thirteen/WNET New York and American Documentary | P.O.V.

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$700 million in potential funding for EHR software

With $700 million in potential funding for EHR software one would think that EHR adoption would be growing more rapidly than current news reports.  A report published in September 2008 by the Certification Commission for Healthcare Information Technology (CCHIT) reviewed 90 EMR incentive programs at the state, private and federal levels. It's interesting to note that only 29 percent of the hospitals surveyed were actively supporting physician EMR adoption with financial or technical support.

In addition, Health Industry Insights (an IDC company) further describes the lag in adoption related to costs. A survey of healthcare payers notes that only one third (35%) indicated they were engaged in initiatives to execute on-line real time claims.

The story continues.

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To stay current on the HITECH Act and its quickly changing regulatory scheme visit the HITECH Survival Guide website and/or sign up for our free monthly compliance newsletter. Also, check out our FREE EHR Checklist.

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Interested in participating in an informal survey on EHR adoption?

Click here to take an informal survey on EHR/PHR adoption. Results will be posted on this blog at a later date.

Department of HHS and CMS implement EHR initiatives

Link: Demonstration Projects & Evaluation Reports.

CMS and the Department of Health and Human Services is implementing an initiative that will foster the adoption of EHRs and health information technology (HIT). The goal of this project is to improve quality of care as well as transform the way medicine is practiced and delivered.

Read more about which states are involved and the CCHIT certified EHR implementation requirements. Incentive payments to physicians will be based on performance of quality measures using HIT to improve care.

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Judge EHRs by their usefulness? What a novel idea!

Link: The Health Care Blog: Judging personal health records by their usefulness.

Technology people are vehicles of change for others. They are the ones that create solutions for the problems of others using technology as the vehicle of change. Often though, they truly don't understand the problems faced by those that will benefit from the change. They don't understand the business. They only understand the vehicle, made from requirements, that many business professionals are unable to fully explain or sometimes understand.

So that raises the question...what is the benefit? What is the problem? How will this tech solution improve the status quo? What is the ROI? Every proposed solution should start with these questions, but most often they don't.

The murky waters of current efforts in EHR/PHRs were built on a foundation of generic requirements and lofty objectives to improve patient care. But these objectives are too obscure to really measure benefit and ROI on investments. We need to get to the heart of the matter. How will electronic health records improve care? 

It starts with an improvement in workflow and efficiency. When considering migration from paper-based health records to electronic ones, its usefulness must be considered. Which stakeholders benefit? The providers? The patient? The insurer? It's often not clear.

With all the existing organizations (both public and private) working to establish the technical aspects of health data exchange and record creation, care of the patient may be lost.

What does the patient want? What does the caregiver want and how will this solution improve the status quo? How will electronic health records improve health?

• It's not the technology. It's how technology is used - the human element, and  effective use of technology, my friends, requires a significant change in culture.
• Culture change is predicated on the ability and desire to change the way things are done.
• In today's litigation-centric world, changing the way care is provided is a scary proposition for many healthcare professionals. Perhaps this explains why healthcare lags behind other industries in effective use of enabling technology.

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To stay current on the HITECH Act and its quickly changing regulatory scheme visit the HITECH Survival Guide website and/or sign up for our free monthly compliance newsletter. Also, check out our FREE EHR Checklist.

If you need tools that will help with your compliance initiatives then check out the HSG Store.