Mary Pat: Your business is called “Health Security Solutions.” People often confuse privacy with security. Can you clear up the confusion for us?
Steve: The Privacy rules refer to the broad requirements to protect the confidentiality of Protected Health Information (PHI) in all its forms. So for example, a physician talking loudly on the phone in the lobby of a restaurant about a patient by name is a violation of the privacy rules. PHI on paper records is covered under the privacy rules.
The security rules are specifically concerned about protecting the confidentiality (i.e. privacy), integrity and availability of electronic PHI, or PHI that exists in a digital form. So once you are dealing with electronic health records and information systems, violations tend to fall under the security rules. (more…)
If you read my alert from August or the followup article on Audit Red Flags to Avoid, you are aware that CMS hired an accounting firm, Figliozzi & Company, to audit the compliance of eligible providers and eligible hospitals that had already received payment under the meaningful use (MU) program. According to a report from the GAO as many as 20% of eligible providers and 10% of eligible hospitals may be audited, on a post-payment basis to confirm that they actually met the requirements of the program.
I recently had the opportunity to interview a physician that is currently going through the audit process with Figliozzi & Company (an edited transcript of the interview can be found here). Although he wishes to remain anonymous, he was willing to report on his experience and provide redacted copies of the correspondence and requests that he has received from the auditors. (more…)
Too often in the rush to upgrade to the newest technology, one basic question that goes unanswered is: “Why are we doing this?”
Because of the ARRA (or “stimulus”) money available to eligible providers, a lot of offices have started or have accelerated plans to upgrade from paper medical records to an electronic medical record (EMR.)
Technology upgrades are not always an easy sell to two of your practice’s critical constituencies: your patients and your staff. I came across this infographic last month from HealthIT.gov that does a great job explaining why practices and the Federal Government are both investing in Electronic Health Record Technology. Content like this also makes a great contribution to your practice blog or email newsletter. Don’t overlook it as part of an in-office announcement of your practice’s transition to EMR. Check it out below or follow this link to healthit.gov.
Today HHS announced a proposed rule (complete rule here – 175 page pdf) that would delay the go live for ICD-10 from October 1, 2013 to October 1, 2014. What follows are excerpts from the proposed rule.
Mary Pat recently sat down with Peter Polack, MD of Medical Practice Trends for another podcast to talk about one of the most important parts of any practice: The Bottom Line. In this two-part podcast series, Dr. Polack and MP discuss ideas for cutting costs and raising revenue to strengthen any group’s financial position.
Mary Pat’s Note: This post has always been popular because it answers one of the most burning questions in Healthcare: “How can I improve my bottom line?” If you have used any of these ideas in your practice- or have some of your own to share- let us know in the comments below!
BUILD ON WHAT YOU’RE CURRENTLY DOING:
1. Add physician hours – add evening or weekend hours; start your office hours earlier and end hours later.
2. Reduce physician time off – decrease vacation or change weekly days off to 1/2 days off.
3. Set a minimum number of providers to be in the office seeing patients at all times the office is open.
4. Have each provider add one new patient visit to his/her schedule weekly.
5. Add ePrescribing to recoup additional Medicare revenue and streamline prescribing (there are free ePrescribing software packages available, but evaluate them carefully so they don’t add more complexity to the system instead of less.)
6. Report PQRI measures to recoup additional Medicare revenue.
7. Charge patients an out-of-pocket fee for completing patient forms – disability forms, etc. and reserve office visits for treating patients.
8. Choose an EMR that qualifies your practice for the ARRA money (although it has been widely promoted that in a larger practice, an EMR and its associated work will cost more than you will get from the government.)
9. If you are in an underserved or rural area, check to see if there might be grants or funds available locally, in the state or federally, for adding a service to your practice.
10. If your practice does Independent Medical Exams (IMEs), reviews records or depositions, make sure that your fee schedule for such services is current and that the fees are collected before the physician provides the service.
For the organized and busy professional on the go, the smartphone has quickly become a necessity on par with a persons house keys, wallet, or purse. The past five years have vaulted the smartphone from status symbol to must-have business tool by bringing data and communication capabilities from your office to the palm of your hand. With decision making and communication tools always at the ready, you can be productive from anywhere you are, and you are freed up to bring information to clients, meetings, and conferences without the hindrance of a laptop.
Physicians, practitioners and forward thinking healthcare organizations are leading the charge to embrace mobile health, often called mHealth, or the practice of patient care supported by mobile devices. A survey conducted at the physician online and mobile community QuantiaMD in May of 2011 found 83% of physicians reported using at least one mobile device and 25% used both a phone and a tablet. Of the 17% surveyed who did not use a mobile device, 44% planned on purchasing a mobile device sometime in 2011. Physicians surveyed reported their top uses for mobile devices as:
Few industries are currently changing as much as the US healthcare system. While many perspectives and ideas are shaping the debate on how to change the system to meet current and future demands, most believe that technology can and will have a huge positive impact on the ability of the industry to deliver quality care in a cost-effective way. Network technologies that can support the ubiquitous exchange of health information in a secure, efficient and collaborative environment hold the potential to streamline and modernize the current system to maximize resources and positive patient outcomes.
The opportunities for improvement have generated a lot of buzz in both the private and public sectors, and incentivizing adoption of Healthcare Information Technology (HIT) through the American Recovery and Reinvestment Act of 2009 (the ARRA or “Stimulus” bill) has led to considerable interest in an industry often known for lagging behind in the adoption of new technologies.
For many, the healthcare-specific technical jargon and operational knowledge of how healthcare works can be as complex as the products themselves. Here then are descriptions of the three types of medical software used by ambulatory care providers.
Practice Management (or PM) Software
Practice Management (or PM) software has been in wide use in the healthcare industry for almost three decades. Its primary use is the collection of patient demographics, patient insurance detail and the healthcare services and related diagnoses provided. This information is formatted to conform to payer requirements and is submitted electronically to request reimbursement for services. PM software also manages the responses from the payers in electronic format and invoices any balance to the patient in the form of printed and mailed statements. PM systems can be all-encompassing in functionality or can be a la carte in modules.
Everybody has been holding their breath to see which EHR software will pass the ONC-ATCB (Office of the National Coordinator for Healthcare IT – Authorized Testing & Certification Body) 2011/2012 certification. Some will buy a system based on this information, and others will continue on with their system feeling a great sense of relief that the system they’ve already paid for is now certified. Still others will wonder if their system of choice has applied and failed, or not applied yet. All this and more information is available on the websites of the three companies that have been approved via the Temporary Certification Program for Health Information Technology.
CCHIT and Drummond announced their first group of certified systems October 1, 2010 and InfoGard has yet to make an announcement.
EHR software companies “…are required to provide complete information on the details of their ONC-ATCB 2011/2012 certification, including company and product name and version, date certified, unique product identification number, the criteria for which they are certified, and the clinical quality measures for which they were tested, and any additional software a complete EHR or EHR module relied upon to demonstrate its compliance with a certification criteria,” states the CCHIT website. This information should be available on the product websites, the certifying body website and the ONCHIT website.
As you are reviewing the bolded product names below, notice that the information is split into separate categories for providers and hospitals, is divided based on the company that certified the EHR and is also broken into complete EHRs software versus software modules.
Complete EHRs for Eligible Providers (CCHIT)
ABEL Medical Software, Inc. for ABELMed EHR – EMR/PM, version 11
Allscripts, Allscripts Professional EHR, version 9.2
Aprima Medical Software, Inc. for Aprima, version 2011
athenahealth, Inc. for athenaclinicals, version 10.10
CureMD Corporation for CureMD EHR, version 10
The DocPatientNetwork.com for Doctations, version 2.0
Epic Systems Corporation for EpicCare Ambulatory – Core EMR, version Spring 2008
GE Healthcare for Centricity Advance, version 10.1
gloStream, Inc. for gloEMR, version 6.0
Intuitive Medical Software for UroChartEHR, version 4.0
MCS – Medical Communication Systems, Inc. for iPatientCare, version 4.0
Medical Informatics Engineering for WebChart EHR, version 5.1
meditab Software, Inc. for IMS, version 14.0
NeoDeck Software for NeoMed EHR, version 3.0
NextGen Healthcare for NextGen Ambulatory EHR, version 5.6
Nortec Software Inc for Nortec Ambulatory EHR, version 7.0
Pulse Systems for 2011 Pulse Complete EHR, version 2011
SuccessEHS for SuccessEHS, version 6.0
EHR Modules for Eligible Providers (CCHIT)
Allscripts for Allscripts Peak Practice, version 5.5
eClinicalWorks LLC for eClinicalWorks, version 8.0.48
NexTech Systems, Inc. for NexTech Practice 2011, version 9.7
nextEMR, LLC for nextEMR, LLC, version 188.8.131.52
Sammy Systems for SammyEHR, version 1.1.248
Universal EMR Solutions for Physician’s Solution, version 5.0
Vision Infonet Inc., for MDCare EMR, version 4.2
WellCentive for WellCentive Registry, version 2.0
Complete EHRs for Eligible Providers (Drummond)
ChartLogic, Inc for ChartLogic EMR 7, version not noted
EHR Modules for Eligible Providers (Drummond)
ifa united i-tech Inc. for ifa EMR, modules 170.302.A-J, 170.302.M, 170.302.O-V (specialized to ophthalmology)
QRS INC. for PARADIGM, version 8.3, modules 170.302.A-W, 170.304.A, 170.304.C-J
Complete EHRs for Hospitals (CCHIT)
Epic Systems Corporation for EpicCare Inpatient – Core EMR, version Spring 2008
EHR Modules for Hospitals (CCHIT)
Allscripts for Allscripts ED, version 6.3
Health Care Systems, Inc. for HCS eMR, version 4.0
PeriGen for PeriBirth, version 4.3.50
Prognosis Health Information Systems for ChartAccess, version 4
I’ve noticed that a lot of people in healthcare seem unusually tired and even, if I dare say so, somewhat cranky. This includes me. I’ve decided we’re all suffering from healthcare fatigue – fatigue from dealing on a daily basis with so much change, uncertainty, and financial stress. Here’s my top ten list of healthcare management stressors accompanied by posts I’ve written that discuss the topic or suggest resources for the challenge.
10. Red Flags Rules – on again, off again, patients don’t want to have their pictures taken or let you copy their driver’s licenses.
9. HIPAA – don’t be fooled, HIPAA is not something we handled years ago and it’s taken care of; there are new requirements and penalties associated with HIPAA breaches. HIPAA is a biggie and something that now infiltrates almost every facet of healthcare.
8. Employment Uncertainty – both for you and your staff – the aftermath of layoffs can be even more demoralizing to those who didn’t lose their jobs. Also, many healthcare entities are still freezing raises. If I hear one more time “we’ll just have to do more with less” I might just scream.
7. Unrealistic Workloads – directly related to #9, most staff and managers have much more work to do than they did just two years ago. Couple that with the ability for managers to be available and work by computer, phone, text message, email or Skype 24/7 and you have fatique that you understand only when you truly, truly stop and wind down for more than three days at a time.
6. Hospitals Buying Practices – this could be a good thing or a bad thing, but as you and I know, change is completely unnerving to most people. Hospitals have very different cultures than private practices and trying to marry the two takes skill, patience and excellent leadership.
5. Stimulus Money for Using EMRs – it’s a big decision and many practices are very nervous about purchasing an EMR. Many think that meaningful use components are unrealistic and even more are fearful of the inevitable productivity drop when the EMR is implemented and for months afterwards.
4. Unhappy Patients – lots of patients are also trying to do more with less (argghhh!) and are avoiding coming to the doctor whenever possible. The front desk staff and the phone staff in particular are getting a lot more heat when they inform patients they’ll have to make an appointment.
2. Medicare Reimbursement – this year has been as exhausting as watching a single point of ping pong played for hours – there will be cuts, there won’t be cuts, there will be cuts, there won’t be cuts. Gird your loins as the November 30 deadline looms for the next potential cuts.
1. The Bottom Line – we have RAC audits, more pre-certification and pre-authorization and pre-notification requirements, more denials, high deductible plans, formularies and 50 other things that are making it difficult to know which hoop to jump through to get paid. Expenses continue to go up, reimbursement continues to go down, and the healthcare world spins faster and harder, making us all wonder when it will, or if it ever will slow down.