EMR Stimulus Q&A: Do You Have to Use a CCHIT Certified EHR Vendor?
Is it necessary to get CCHIT certified vendor just because you want to qualify for incentives or regardless you MUST go for a certified solution?
Because I make the case that one should go with the one that provides the most amount of value.
You only need to use a certified EHR (doesn’t have to be CCHIT certified either, but HHS Certified) if you want to get the EMR stimulus money. The only caveat is that if you don’t show “meaningful use” of a “certified EHR,” then in a few years there are 1-5% Medicare penalties for not using one and showing meaningful use.
So, there’s nothing forcing physicians to use a certified EMR solution. More and more people are doing as you describe, ” go with the one that provides the most amount of value.” They make the valid argument that if you get $44k in EMR stimulus money and lose $50k in productivity then you would have been better to go with an EMR that can’t get you stimulus money, but still maintains or even improves your productivity (among other EMR benefits).
At one of my EMR stimulus speaking engagements, a physician came up to me after the presentation and asked, “If I don’t accept Medicare or Medicaid, then do I care about meaningful use or certified EHR?” The easy answer was, nope. He can just decide on the right EMR without having to worry about government requirements.
Mr Lynn
EMR & HIPAA
7-29-10
Thursday, July 29, 2010
Wednesday, June 9, 2010
Electronic Prescriptions for Controlled Substances
Electronic Prescriptions for Controlled Substances
--------------------------------------------------------------------------------
On March 24, 2010, the Office of the Federal Register made available for public inspection an Interim Final Rule with Request for Comment from the Drug Enforcement Administration (DEA) entitled “Electronic Prescriptions for Controlled Substances” [Docket No. DEA-218, RIN 1117-AA61]. On March 31, 2010 the rule was published in the Federal Register. The official rule may be viewed at the Federal Register Web site. An unofficial copy of the rule is found below. The rule will become effective June 1, 2010.
The rule revises DEA regulations to provide practitioners with the option of writing prescriptions for controlled substances electronically. The regulations also permit pharmacies to receive, dispense, and archive these electronic prescriptions. These regulations are an addition to, not a replacement of, the existing rules. The regulations provide pharmacies, hospitals, and practitioners with the ability to use modern technology for controlled substance prescriptions while maintaining the closed system of controls on controlled substances.
U.S. Department of Justice
Office of Diversion Control
June 9, 2010
--------------------------------------------------------------------------------
On March 24, 2010, the Office of the Federal Register made available for public inspection an Interim Final Rule with Request for Comment from the Drug Enforcement Administration (DEA) entitled “Electronic Prescriptions for Controlled Substances” [Docket No. DEA-218, RIN 1117-AA61]. On March 31, 2010 the rule was published in the Federal Register. The official rule may be viewed at the Federal Register Web site. An unofficial copy of the rule is found below. The rule will become effective June 1, 2010.
The rule revises DEA regulations to provide practitioners with the option of writing prescriptions for controlled substances electronically. The regulations also permit pharmacies to receive, dispense, and archive these electronic prescriptions. These regulations are an addition to, not a replacement of, the existing rules. The regulations provide pharmacies, hospitals, and practitioners with the ability to use modern technology for controlled substance prescriptions while maintaining the closed system of controls on controlled substances.
U.S. Department of Justice
Office of Diversion Control
June 9, 2010
Tuesday, June 8, 2010
Revolution In The Evolution Of The Electronic Health Record
The healthcare IT world is abuzz with excitement because the Electronic Health Record has finally gained recognition as a critical element in the restructuring of healthcare. For years Democrats and Republicans, clinicians and administrators have all talked about how automation would create the missing efficiency in the healthcare system. But, in reality, little was done about increasing the rate of EHR adoption.
Financial healthcare transactions received a boost in 1996 when HIPAA established rules for the use of electronic claims and other financial transactions. Since then electronic financial transaction volume in healthcare has climbed dramatically, benefitting all.
Electronic prescribing also received a nudge in 2003 from the Medicare Modernization Act, which established rules for the use of electronic prescribing and provided mandates and financial incentives. As a result ePrescribing has steadily gained traction, resulting in increased efficiency and lower medication errors.
Most recently, the economic downturn spurred the American Recovery and Reconstruction Act of 2009 which committed $19 billion to healthcare information technology. The Health Information Technology for Economic and Clinical Health Act, or the "HITECH" portion of ARRA, established standards, implementation specifications, and certification criteria for EHR technology. It also established programs under Medicare and Medicaid to provide financial incentives, including payments and penalties, to encourage the "meaningful use" of EHRs. (The full 556-page document defining meaningful use can be downloaded here).
Healthcare is one of the most information intensive industries, yet it has been one of the least automated. Today, many life and death decisions are made by physicians using barely readable documents transmitted by decades old FAX machines. Other developed countries, such as Denmark, are far ahead of the US in adoption of EHRs. The US needs automation to increase efficiency and reduce errors. The core functionality for healthcare clinical automation is the Electronic Health Record, also known as the Electronic Medical Record.
To understand EHR adoption in today’s US market, it is important to understand “Meaningful Use” the incentive scheme used by ARRA to motivate providers and hospitals to adopt and utilize EHRs. Proposed rules were issued on December 30th and final rules are expected by late spring
According to the proposed rules, hospitals will be measured by 23 indicators of meaningful use which will become increasingly stringent over time. A recent article in HealthCare IT News summarizes the 23 Stage 1 Meaningful Use criteria for eligible hospitals. These criteria include:
Communicating clinical orders electronically
Automatically checking for unintended drug interactions
Maintaining an up-to-date problem list of current and active diagnoses
Keeping an electronic list of each patient’s medications
Maintaining a list of the patient’s medication allergies
For doctor’s offices, there are 25 indicators of meaningful use. These include many of the same indicators as those used for hospitals. The full list is available here. Some examples are:
Recording and charting changes in vital signs
Recording smoking status
Incorporating clinical lab results as structured data
Generating lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, and outreach
Since the announcement of Meaningful Use, a great debate has arisen among EHR vendors and pundits. Many complain that Meaningful Use will delay adoption as hospitals and physicians wait to see which EHR vendors survive the certification process. Others say that Meaningful Use is stifling innovation as vendors focus their development efforts on fulfilling Meaningful Use requirements rather than inventing new features and functions.
However, one could argue that Meaningful Use does not promote technology for technology’s sake but instead requires providers and hospital to use EHRs to reduce medical errors and more effectively care for patients. This regulation could drive the transformation of American medicine in a positive direction, reducing medication errors and facilitating evidence-based medical practices.
Healthcare vendors may need to face the fact that EHR adoption and utilization in the US has been growing at a pitifully slow rate. Even if Meaningful Use creates a few initial hiccups, it is difficult to imagine that this innovative regulatory scheme, along with $19 billion dollars, won’t pick up the pace of EHR adoption as well as innovation.
MedHealthWorld
Ed Daniels
June 3, 2010
Financial healthcare transactions received a boost in 1996 when HIPAA established rules for the use of electronic claims and other financial transactions. Since then electronic financial transaction volume in healthcare has climbed dramatically, benefitting all.
Electronic prescribing also received a nudge in 2003 from the Medicare Modernization Act, which established rules for the use of electronic prescribing and provided mandates and financial incentives. As a result ePrescribing has steadily gained traction, resulting in increased efficiency and lower medication errors.
Most recently, the economic downturn spurred the American Recovery and Reconstruction Act of 2009 which committed $19 billion to healthcare information technology. The Health Information Technology for Economic and Clinical Health Act, or the "HITECH" portion of ARRA, established standards, implementation specifications, and certification criteria for EHR technology. It also established programs under Medicare and Medicaid to provide financial incentives, including payments and penalties, to encourage the "meaningful use" of EHRs. (The full 556-page document defining meaningful use can be downloaded here).
Healthcare is one of the most information intensive industries, yet it has been one of the least automated. Today, many life and death decisions are made by physicians using barely readable documents transmitted by decades old FAX machines. Other developed countries, such as Denmark, are far ahead of the US in adoption of EHRs. The US needs automation to increase efficiency and reduce errors. The core functionality for healthcare clinical automation is the Electronic Health Record, also known as the Electronic Medical Record.
To understand EHR adoption in today’s US market, it is important to understand “Meaningful Use” the incentive scheme used by ARRA to motivate providers and hospitals to adopt and utilize EHRs. Proposed rules were issued on December 30th and final rules are expected by late spring
According to the proposed rules, hospitals will be measured by 23 indicators of meaningful use which will become increasingly stringent over time. A recent article in HealthCare IT News summarizes the 23 Stage 1 Meaningful Use criteria for eligible hospitals. These criteria include:
Communicating clinical orders electronically
Automatically checking for unintended drug interactions
Maintaining an up-to-date problem list of current and active diagnoses
Keeping an electronic list of each patient’s medications
Maintaining a list of the patient’s medication allergies
For doctor’s offices, there are 25 indicators of meaningful use. These include many of the same indicators as those used for hospitals. The full list is available here. Some examples are:
Recording and charting changes in vital signs
Recording smoking status
Incorporating clinical lab results as structured data
Generating lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, and outreach
Since the announcement of Meaningful Use, a great debate has arisen among EHR vendors and pundits. Many complain that Meaningful Use will delay adoption as hospitals and physicians wait to see which EHR vendors survive the certification process. Others say that Meaningful Use is stifling innovation as vendors focus their development efforts on fulfilling Meaningful Use requirements rather than inventing new features and functions.
However, one could argue that Meaningful Use does not promote technology for technology’s sake but instead requires providers and hospital to use EHRs to reduce medical errors and more effectively care for patients. This regulation could drive the transformation of American medicine in a positive direction, reducing medication errors and facilitating evidence-based medical practices.
Healthcare vendors may need to face the fact that EHR adoption and utilization in the US has been growing at a pitifully slow rate. Even if Meaningful Use creates a few initial hiccups, it is difficult to imagine that this innovative regulatory scheme, along with $19 billion dollars, won’t pick up the pace of EHR adoption as well as innovation.
MedHealthWorld
Ed Daniels
June 3, 2010
Tuesday, April 20, 2010
More Doctors Prescribing Meds Electronically
Doctors are increasingly prescribing medications electronically, abandoning the traditional paper scripts that can result in drug errors due to hard-to-read writing or coverage denials by a patient's insurer.
The number of e-prescriptions nearly tripled last year to 191 million from the previous year's 68 million, representing about 12% of the 1.63 billion original prescriptions, excluding refills, according to Surescripts LLC, whose online network handles the bulk of the electronic communications. The growth has accelerated. For the first three months of this year, nearly one in five prescriptions was filed electronically, Surescripts says. About 25% of all office-based doctors currently have the technology to e-prescribe, more than twice as many as at the end of 2008, Surescripts says.
E-prescription programs display lists of drugs for doctors to select from. Symbols may indicate the cheapest or best option for the patient.
Industry officials expect the growth in e-prescribing to continue, helped in part by a regulatory ruling last month that will soon allow doctors to start prescribing controlled medications such as narcotics and anti-depressants electronically. Under Drug Enforcement Administration rules, doctors previously had to hand out paper prescriptions for controlled drugs, even while other drugs could be e-prescribed.
The recent DEA ruling "is what we've all been waiting for," says John Halamka, an emergency-room physician at Beth Israel Deaconess Medical Center in Boston, who has used e-prescribing for three years. Being able to digitally zap some prescriptions to a pharmacy, while having to use a pad and paper for other medicines has disrupted work flow at the hospital, he says. "Now we can write prescriptions for [cholesterol drug] Lipitor and Valium [a controlled anti-anxiety medication] on the same program," he says.
Doctors transmit e-prescriptions via a secured Internet network directly to pharmacies from their computers or hand-held devices. Nearly all chain drug stores and 62% of independent pharmacies now accept e-prescriptions that are uploaded directly to their computers. For medical practices, the cost of e-prescribing software and hardware, such as laptops, as well as training can range from about $1,000 to $1,750 per physician, according to software makers.
Displayed on the doctor's e-prescribing screen are an array of drugs and their prices. Doctors select among different doses and either generic or name-brand medications. Also listed are which medications are covered, and which are not, by a patient's insurance company. For some e-prescribing programs, symbols in the form of small faces appear on the screen: A green smiley face means the medication will be the cheapest for a patient, or that it's the preferred drug based on other medications the patient is taking. Yellow and red faces indicate less desirable options.
"Wall Street Journal April 20, 2010"
The number of e-prescriptions nearly tripled last year to 191 million from the previous year's 68 million, representing about 12% of the 1.63 billion original prescriptions, excluding refills, according to Surescripts LLC, whose online network handles the bulk of the electronic communications. The growth has accelerated. For the first three months of this year, nearly one in five prescriptions was filed electronically, Surescripts says. About 25% of all office-based doctors currently have the technology to e-prescribe, more than twice as many as at the end of 2008, Surescripts says.
E-prescription programs display lists of drugs for doctors to select from. Symbols may indicate the cheapest or best option for the patient.
Industry officials expect the growth in e-prescribing to continue, helped in part by a regulatory ruling last month that will soon allow doctors to start prescribing controlled medications such as narcotics and anti-depressants electronically. Under Drug Enforcement Administration rules, doctors previously had to hand out paper prescriptions for controlled drugs, even while other drugs could be e-prescribed.
The recent DEA ruling "is what we've all been waiting for," says John Halamka, an emergency-room physician at Beth Israel Deaconess Medical Center in Boston, who has used e-prescribing for three years. Being able to digitally zap some prescriptions to a pharmacy, while having to use a pad and paper for other medicines has disrupted work flow at the hospital, he says. "Now we can write prescriptions for [cholesterol drug] Lipitor and Valium [a controlled anti-anxiety medication] on the same program," he says.
Doctors transmit e-prescriptions via a secured Internet network directly to pharmacies from their computers or hand-held devices. Nearly all chain drug stores and 62% of independent pharmacies now accept e-prescriptions that are uploaded directly to their computers. For medical practices, the cost of e-prescribing software and hardware, such as laptops, as well as training can range from about $1,000 to $1,750 per physician, according to software makers.
Displayed on the doctor's e-prescribing screen are an array of drugs and their prices. Doctors select among different doses and either generic or name-brand medications. Also listed are which medications are covered, and which are not, by a patient's insurance company. For some e-prescribing programs, symbols in the form of small faces appear on the screen: A green smiley face means the medication will be the cheapest for a patient, or that it's the preferred drug based on other medications the patient is taking. Yellow and red faces indicate less desirable options.
"Wall Street Journal April 20, 2010"
Monday, April 12, 2010
Stimulus Money Available to Implement Electronic Medical Records
With federal stimulus money available to defray the cost of going high tech, physicians and hospitals across the area are looking to get rid of paper in favor of electronic medical records.
And with cuts coming to Medicare and Medicaid reimbursements in 2015 for those that don’t make the switch, many doctors and hospitals are preparing to go electronic now.
“There’s a revolution coming,” said Peter A. Levine, executive director of the Genesee County Medical Society. “There are a lot of physicians’ offices looking at this right now, but have not made decisions yet. The process of selecting an electronic medical records system is pretty complicated.”
An estimated 44 percent of office-based physicians used at least some electronic medical or health records in 2009, according to the National Center for Health Statistics. But only about 6.3 percent of those doctors are using a fully functional electronic system, according to the center.
The stimulus funding provides about $19 billion for Medicare and Medicaid health information technology incentives over a five-year period. Doctors and hospitals that adopt use of electronic medical records and show a “meaningful use” of the technology can receive incentives of about $44,000 per physician.
Flint Journal 4-11-10
And with cuts coming to Medicare and Medicaid reimbursements in 2015 for those that don’t make the switch, many doctors and hospitals are preparing to go electronic now.
“There’s a revolution coming,” said Peter A. Levine, executive director of the Genesee County Medical Society. “There are a lot of physicians’ offices looking at this right now, but have not made decisions yet. The process of selecting an electronic medical records system is pretty complicated.”
An estimated 44 percent of office-based physicians used at least some electronic medical or health records in 2009, according to the National Center for Health Statistics. But only about 6.3 percent of those doctors are using a fully functional electronic system, according to the center.
The stimulus funding provides about $19 billion for Medicare and Medicaid health information technology incentives over a five-year period. Doctors and hospitals that adopt use of electronic medical records and show a “meaningful use” of the technology can receive incentives of about $44,000 per physician.
Flint Journal 4-11-10
Wednesday, March 24, 2010
EMR Trends
Summary
Traditionally, larger EMR vendors were thought to have advantages over smaller providers
For smaller practices, a smaller EMR vendor may be more attractive because of price and infrastructure
There should be a large push in 2010 for small practices to adopt EMR's because of the government incentives available in 2011
Analysis
The conventional belief in electronic medical records (EMR) has always been that the bigger the better. The idea was that larger providers of EMR's, such as GE Healthcare or Allscripts, offered stability to reassure physicians that their EMR service was going to being secure for many years. In addition, by choosing a larger provider, physicians may reap the benefits of being part of a larger market share where compatibility with other providers may be made easier.
However, for several reasons, the marketplace has begun to shift its attention towards smaller EMR providers. The larger vendors had initially targeted large institutions such as hospital networks. As a result, their infrastructure and pricing tends to neglect the small practice, which has been the slowest adopter of EMR's.
In 2011, government incentives will begin for practices who are using EMR's. Therefore, look for 2010 to be a buyer's market as practices begin to adopt EMR's, and in all likelihood, this will be a boon for smaller EMR vendors.
GLG Healthcare Council
Money.CNN.Com March 2010
Traditionally, larger EMR vendors were thought to have advantages over smaller providers
For smaller practices, a smaller EMR vendor may be more attractive because of price and infrastructure
There should be a large push in 2010 for small practices to adopt EMR's because of the government incentives available in 2011
Analysis
The conventional belief in electronic medical records (EMR) has always been that the bigger the better. The idea was that larger providers of EMR's, such as GE Healthcare or Allscripts, offered stability to reassure physicians that their EMR service was going to being secure for many years. In addition, by choosing a larger provider, physicians may reap the benefits of being part of a larger market share where compatibility with other providers may be made easier.
However, for several reasons, the marketplace has begun to shift its attention towards smaller EMR providers. The larger vendors had initially targeted large institutions such as hospital networks. As a result, their infrastructure and pricing tends to neglect the small practice, which has been the slowest adopter of EMR's.
In 2011, government incentives will begin for practices who are using EMR's. Therefore, look for 2010 to be a buyer's market as practices begin to adopt EMR's, and in all likelihood, this will be a boon for smaller EMR vendors.
GLG Healthcare Council
Money.CNN.Com March 2010
Stimulus Fuels Push for Electronic Medical Records
Under the stimulus law, medical offices that buy or update electronic systems can receive up to $44,000 in bonus Medicare payments per doctor over five years, starting in 2011. They can get the money regardless of how much they pay for the unit. Hospitals are eligible for a $2 million bonus payment in the first year, millions more later on.
Congress jolted the market by rewarding doctors and hospitals that jump on board quickly and penalizing those who resist. The faster they get up and running, the more money they can get. On the flip side, Medicare plans to cut payments to those who fail to get wired up by 2015.
"The law is very well crafted," said John D. Halamka of Harvard Medical School, who is vice-chairman of a government advisory panel on health technology standards.
Halamka's advice to doctors and hospitals? Start shopping.
Federal Computer Week Jan. 2010
Congress jolted the market by rewarding doctors and hospitals that jump on board quickly and penalizing those who resist. The faster they get up and running, the more money they can get. On the flip side, Medicare plans to cut payments to those who fail to get wired up by 2015.
"The law is very well crafted," said John D. Halamka of Harvard Medical School, who is vice-chairman of a government advisory panel on health technology standards.
Halamka's advice to doctors and hospitals? Start shopping.
Federal Computer Week Jan. 2010
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