Posts Tagged ‘EMR’
MU 101: Intro to “Meaningful Use”
Our nation’s health
care system is undergoing a massive transformation to improve the quality, safety and efficiency of care. To catalyze this transformation CMS has create the ARRA HITECH incentive program for eligible Medicare and Medicaid providers who demonstrate ‘meaningful use’.
These providers will not only reap benefits from the financial payments, but will see a reduction in errors, higher availability of records and data, new reminders and alerts, and unprecedented clinical support and electronic prescribing capabilities.
Beginning next year, eligible physicians who see Medicare and/or Medicaid patients will be compensated from $44,000 to $65,000 over a 5 year term for fulfilling the recently defined ‘meaningful use’ criteria. To further promote the use of certified systems, if these same physicians do not utilize healthcare IT that meets the Federal requirement by 2015, they will be faced with increasing penalties of up to 5%.
One very important part of these incentives is the ability for providers to implement individual certified modules that when used together, meet the meaningful use criteria. Many doctors believe that a paperless EHR is the only way to reach meaningful use, but it is important for them to realize that they have options to use modular systems to achieve the requirements!
Stayed tuned to our blog as we dissect the upcoming Meaningful Use incentives – see below for a schedule of topics to come:
- Part 1: Medicare
- What is required and how do I get paid?
- Who is eligible?
- How hard is it to meet?
- Part 2: Medicaid
- State specific requirements
- What does Modular Approach Mean?
- What is a Patient Registry?
- What is Attestation?
- Checklist for Meeting MU: What are the 15 components and 5 (10) Menu items?
- Should you go paperless or not? Is your office ready?
- Questions you should ask your EMR?
- What’s in a guarantee for MU?
- Who are the certification bodies?
- What is expected for stage 2?
- MU 101: Final Review
I’ve been trying out an iPad for the past 2 weeks. It’s a WiFi-only model (no AT&T data service), and I’m very facile with a computer—and almost always have one with me—so the iPad would have to be very good to impress me. I’ve also tried e-prescribing on the iPhone (well, Generation I, so pretty slow) and Android phones, and found both very slow even with WiFi; good only for occasional use like nights and weekends in my opinion. But the iPad is a very different story. It’s snappy with good connection speed and a very snappy processor. Apple has also changed handling of pop-up menus which are much smoother to use than the old bottom-of-the-screen iPhone solution. I could use this device for all my e-prescribing without any concern.
Remember, though, that this is really more of a smart phone than a computer, based on the iPhone operating system. So I decided to see how it would work using it for other things as well. I’ve use it for ePocrates, email (using the on-screen keyboard in landscape mode), internet surfing, a few games (whoa…stay away from that – can you say addictive!), videos (note: Flash doesn’t work, but YouTube serves up videos that do work), music, and even LogMeIn to control my computer. For things where there’s a native app like email, web surfing and music (it is, after all, an iPod of sorts), it’s great. Controlling my computer worked, but without a mouse it was a little clumsy. I also used it to take notes in meetings using a couple of different free note apps, and that worked very well. Photo-editing, not so much.
So here’s the bottom line. It’s a snazzy device with a good form factor; and, due to the processor speed and native apps, it works really well for routine chores including e-prescribing. It’s not a full computer, but the on-screen keyboard works well (there are wireless keyboards available but I haven’t tried those, nor do I need one). I wouldn’t use it for EMR, photo/video editing, or spreadsheet work, but I have found myself more and more often carrying the iPad with me instead of my notebook computer.
On July 13th HHS and the Office of the National Coordinator (ONC) released the “Final Rule” on Meaningful Use for EHRs (864 pages). This document lays out the requirements to qualify for the ARRA reimbursements in Stage I under CMS administration with the program starting in January 2011. The Rule for certifying EHRs to include certain standards (228 pages) was also released at that time, though for most physicians the former is far more important.
Most of the initial reactions were very positive, though in the past week some more nuanced comments have emerged along with critiques of the HHS reality checking engine assumed in the time line for adoption by physicians, especially small practices.
The American Medical Association (AMA) was one of the few organizations that did not issue a statement immediately. Their more detailed comments were encompassed in a 34 page memo to the AMA Board of Trustees on July 20th and in a press release on the 21st under the name of Steven Stack, MD, a Trustee who is an Emergency Room Medical Director from Kentucky and the AMA spokesperson for Health IT.
Here is an excerpt from his statement that addresses some of the problematic issues while overall complementing ONC and CMS for their efforts:
“Despite CMS’ attempt to simplify the meaningful use requirements, challenges remain. Among the concerns are questions about product availability, the tight time line for adoption and the high overall number of measures physicians are required to meet. While the volume of measures was reduced overall, the final rule requires physicians to meet 20 measures in the first year which is still too high, especially for smaller practices that are new to the technology.”
Currently there is no EHR in the market that does all the things required for physicians to successfully meet meaningful use criteria. CMS expects EHR systems that support meaningful use to become available this fall, giving physicians just a few months to purchase, implement and assess the usability of EHR technology before the January 1, 2011 start date of the incentive program. This is no small feat, considering it can take a year or more to purchase and implement an EHR system.
Some journalists and commentators are quick to claim that the AMA position does not carry much weight since most physicians are not members. This fails to recognize that, at well over 200,000 members, the AMA is still almost twice as large as the next largest medical association, the American College of Physicians (ACP). It is the only large professional association that has continuously, over many years, advocated in both governmental and private sectors for all physicians, regardless of specialty or membership status and has been vigorous in its position for safe, effective patient care and for physcians’ tools that are affordable and easy to use.
However, the “elephant in the room” – the SGR fix – is not mentioned in most of the commentary on the final rule which has the potential to put the additional reimbursements of $44-65k to physicians over a 4-6 year period in the proper context.
The looming 23% Medicare payment reduction that is continuously put off by Congress (recently pushed back to November 30th, and increased to 30% on January 1st) is the larger focus of the AMA at present. After years of Congress delaying a permanent SGR fix of the physician reimbursement formula, the cost of a “final fix” now runs well over $100 billion in the funny money accounting that goes on at the federal level. This amount dwarfs the ARRA meaningful use stimulus money for physicians and illustrates, in part, why the AMA feels more needs to be done to help physicians, especially small practices that can’t afford expensive IT systems and the ongoing training and support they require.
We at Dr First are well aware of all these developments and have been involved deeply and over a long time in making clinical IT systems simple, powerful and affordable. We were the first IT vendor to be chosen to take part in the AMA cloud computing initiative after they searched nationwide for the best eRx system to help launch their web based “Software as a Service platform (SAAS). Gradually, their system will offer more modules to help meet the Final Rule requirements.
On the other hand, the current Rcopia platform, and its soon to come innovative modules, offers the best bang for the buck for small practices, along with the ability to upgrade to any of more than 100 EMR applications that are represented in our DrFirst Partners program.
Sure, the financial incentives from the Federal government for e-prescribing are indeed a welcome bonus, but over the long haul, the operational benefits you’ll realize will go far beyond the dollars you will accrue from those programs and will result in even more dollars to your practice.
But how do you measure the return on investment? Sure, you and your staff will more efficiently handle phone calls regarding prescriptions. Sure, your staff will not need to pull as many charts for phone calls… but what does that translate to in $$$?!
The MGMA study now concludes that electronic prescribing results in average savings of $75 to $1506 per day per physician!
(Per FTE physician TOTAL PER YEAR savings 336.7 hours and $15,769!)
DrFirst is proud to pass the 100 health IT vendor partner milestone, securing our Open Borders Program as the first choice for e-prescribing integration. With over 6 years of experience, DrFirst has helped over 20 certified partners successfully pass CCHEALTH IT and preliminary ARRA/HITECH certifications for all electronic prescribing requirements.
In 2004, DrFirst began providing E-prescribing software solutions to other Healthcare Information Technology (health IT) vendors in a program called “Open Borders”. During the process, we adopted a corporate strategy to work with Electronic Medical Record (EMR/EHR), Practice Management System), and other health IT software developers to bring the true power of electronic prescription management to their clients, freeing their development resources from the costs associated with creating their own e-prescribing infrastructure in-house. Since 2004, DrFirst has helped more health IT vendors launch successful integrated E-prescribing solutions to market than any other E-prescribing vendor through its mature processes within the “Open Borders” division devoted to delivering these services.
Here’s what one of our long time partners has to say about the DrFirst experience:
“We integrated DrFirst’s E-prescribing portal with our Ambulatory EMR/EHR last year. Access to the electronic prescribing service has been a phenomenal success for not only our physician customers, but for their patients as well. Of utmost benefit, we’ve eliminated duplication of effort, as the user logs in just once, and all relevant clinical and eligibility information is shared between the systems.”
Michael Andraychak
Product Manager
Healthland
Survey Shows Increased Confidence in Meeting Meaningful Use for Healthland Users
Healthland, a DrFirst Certified Partner, has just released the results collected from a February, 2010 survey on the ARRA incentives and Meaningful Use criteria at the HIMSS10 Conference.
The study surveyed over 100 critical access and small community hospitals from across the country, asking respondents to share how they feel their knowledge of the ARRA incentives and Meaningful Use guidelines has changed compared to just 1 year ago.
