ICD-10 overview: Is your EHR ready to help with the transition?

ICD-10, the new coding system that the providers should be compliant by October 1, 2014, is a challenge; needless to say this is a truism. ICD-10 is worrisome for everyone, let alone the big healthcare organizations. ICD-10 has 68,000 codes, as opposed to the 13,000 in ICD-9; this requires expertise, time and trainings at same time. The EHR vendors will be required to meet the standards of criteria and implement it smoothly.

Many codes of ICD-10 are built on the existing codes of ICD-9. With ICD-10 translation support tools, directly built in your EHR many of the ICD-9 codes can be used to navigate using translation tools. EHR transition from ICD-9 to ICD-10 is an arduous challenge for the developers too, because the EHR system is filled with bugs and removes them from requiring provider’s feedback.

The headache lies in providers who will have to familiarize themselves with new ICD-10 codes and standards. With the EHR system, they will still need extensive training for themselves and their staff in order to deliver. If the provider’s biller makes a mistake in coding, the result will be no revenue in shape of denied claims. EHR provides tools to allow easy cross over; tools from both ICD-9 and SNOMED are provided inside the EHR to eliminate the need to memorize the differences between codes as the system will adjust to itself. The compliance will be managed automatically.

How easy will the EHR make the transition from ICD-9 to ICD-10 for you? In fact, let’s exaggerate a little bit; it will be very easy at least easier than your current workflow. Not knowing the code for a specific condition you will be able to far more range of diseases with just a few clicks and with minimal effort through the use of advanced search built in tools. Searching through the system helps you identify the code, and ensures they are apposite and billable.

A comparison of Fee-for-service and Pay-for-Performance payment models

Payment models are the basis by which healthcare industry works. At the end of the day, providers need to get paid in order to thrive. But which model is successful? Which model delivers results needed by the healthcare system as a whole?  

Pay-for-performance is a relatively new concept gaining fame. The idea is to improve care by improving quality and reducing costs. Fee-for-service is a model aimed at delivering as much services as possible in order to generate more money. 

In a Fee-for-service (FFS) model the charges for each service provided to the patients are different. In essence, this model helps physicians make more money as providers are able to provide a host of services in a package. In this model quality suffers, as it is primarily not the focus of the physician, but at the same time revenue generation flows. FFS has caused increase in medical costs over the period of time. Government is not in favor of this model as physicians are able to misuse the system, and strategically wants to phase it out. Everyone wants money; likewise, physicians are lured to make more money through this structure which should be the secondary aim of the doctor, patient’s quality care should always come first. 

Pay-for-performance (P4P): Quality of service pays the provider, in this model. The criteria in terms of quality increase the efficiency of the provider; and, likewise, incentives are based on the quality of work done by the physician. This is a method by which physicians remain vigilant. Accountable Care Organizations follow this model, and according to a report by Oliver Wyman, a leader in global management consulting, 14% Americans are now being served by an ACO. ACOs through coordinated care delivery system not only provide high quality care, but are able to save huge costs by sharing their resources among different healthcare facilities falling under ACO. Finally, the share of costs saved, is divided among healthcare providers.

By all means, P4P model is better than FFS model. Government’s focus to move away from the old model is the proof. With the use of EHRs P4P can be made easier and possible. The shift in adoption is slow but with the use of technology this can be made significantly faster especially with those spicy incentives that are being introduced for the shift.

Is your EMR consultant up to speed?

EMR consultants are in way much more demand than ever before. With the announcement of government’s plans of incentive payments to eligible EMR users, physicians and healthcare providers are using these systems a lot than before.
Therefore, a consultant’s job is not easy anymore. They need to keep pace with all the latest happening in the world of healthcare. But how do you find out if your EMR consultant is up to speed? 

Let’s find out.

Competitor knowledge
Your EMR consultant must have a thorough understanding of all the competitors in the market that are out there. He/she must be able to tell their strengths and weaknesses and should be able to narrow the choices down for you keeping in mind your exact requirements.

Government policies
The Healthcare sector is evolving with every passing day. It is very important for your EMR consultant to be aware of the regulatory changes that are taking place. Knowledge of all the laws governing the usage of EMR system is a must. 

Meaningful Use policies
While Meaningful Use Stage 1 was fairly easy to implement, Stage 2 is quite difficult to understand properly. According to a research, only 5% of the physicians and hospital networks meet Stage 2 requirements. You must confirm that your EMR consultant has all the knowledge when it comes to Meaningful Use Stage 2 and is able to help you choose a software which will comply with it.

Associated costs
Costing is also a crucial aspect your EMR consultant needs to be aware of. He/she should know detailed pricing plans for all the products available in the market and must be able to select the one that meets your requirements and budget.

ROI analysis
Another important aspect of a good EMR consultant is his/her ability to make a ROI analysis. Total software costs, setup costs, hardware costs, support and maintenance and its impact on productivity are some of the factors must be evaluated in a ROI analysis by your EMR consultant.

KPI Dashboards – Information That Matters

Corporations have unified under the umbrella of the current economy with the objective to do more with less. For companies deploying and using Electronic Medical Records, the extraction of information from large storage spaces is crucial.

Electronic Medical Records have the capability of information storage, access and retrieval and to further its use, it needs to be interoperable.

In the identification of key performance indicators (KPIs), defining detrimental metrics and the provision of accessible data to users is the main and first hurdle. One of the biggest challenges in dashboard implementation is a clear definition of important KPIs and the best methods to represent them.

Not being able to afford clinical errors, physicians are usually short on time and often can overlook important administrative and financial objectives, paving the need for Electronic Medical Records.
Through Meaningful Use and other clinical standards, doctors have a lot to settle with Electronic Medical Records.  As a result, major EMR vendors have designed and embedded “Meaningful Use” KPIs for real-time graphical representation of compliance with objectives of clinical nature in their mind.
Customizable dashboards allow users to search, drill down and even update the presented information – saving time, streamlining workflow, maintaining the accuracy of records and focusing user’s actions on the positive outcome of key metrics.
Reflecting the most important information,  physicians often overlook customizable dashboards when selecting EMR software. It is crucial for the physician community to understand their importance.

EMR – The Untold Story

Healthcare EMR
The last few years have been monumental for the healthcare in the US. With the introduction of the American Reinvestment and Recovery Act (ARRA), the government laid down the foundation for a new structure in order to improve healthcare delivery. EMRs has always been on the forefront, taking most of the fire. The government along with numerous healthcare professionals believes in the value of healthcare automation. However, EMRs are merely facilitators while physicians are still responsible for delivering quality healthcare.

With an estimate of $6600 in healthcare costs being spent on an individual per annum, the effectiveness of the ARRA is instrumental in re-shaping the future of healthcare. “The government cannot afford any hiccups. We are all too far invested in this for it not to work.” comments a healthcare IT executive. “$6600? I don’t see it. Where is it going? You step out right now and look around you tell me if you can spot one individual that had 6600 spent on their health, one individual.” remarked a construction worker from New Jersey, during an independent survey.

The Meaningful Use requirements provide an effective roadmap for delivering quality healthcare. Its objective is to ensure that physicians learn how to effectively utilize EMRs and improve healthcare delivery. CMS introduced this exercise to help physicians realize what an EMR is capable of and how it adds to their care quality.

Likewise, the Affordable Care Act reforms have resulted in better EMR adoption rates. The government believes that there is at least $300 billion to be saved through standardization of health information technology. However, despite the expected benefits, there is still lot of skepticism surrounding EMRs. Many physicians believe that EMRs in fact do not add to practice productivity, but instead slow them down while increasing their overheads.

In a recent study by Danny McCormick and David Bor of Cambridge Health Alliance and Stephanie Woolhandler and David Himmelstein of CUNY School of Public Health indicated that EMRs may actually increase the frequency of tests ordered by physicians. More than 28,700 of patient visits and nearly 1,200 doctors were surveyed to determine the outcome. The study shows that physicians utilizing EHRs were 5% more likely to order imaging, rather than doctors who did not.

Danny McCormick believed that it was important to point out the contrast of the actual findings with the commonly constructed belief of EMRs decreasing health costs. However, he went on to state that it is attributable to the enhanced interoperability provided by EMRs that doctors can expect to get results faster and can easily view them on their screens.

Dr. David Blumenthal, who served as the national coordinator for Health IT at the Department of Health and Human Services from 2009-2011, pointed out that the study represents order of tests and not costs. He went on to state that the study does not take into account the overall impact of EHRs and accumulative healthcare costs. “The study doesn't look at the benefits for quality of care at all. It's possible that the use of tests by some of the doctors could have avoided other costs. This study has no way of assessing the overall implications of the behavior that it's finding.”

Dr. Farzad Mostashari who is the National Coordinator for Health IT also voiced similar concerns in his reply. He believes that the study showed little evidence and did not consider the impact of EMRs in improving healthcare delivery. He also pointed out that due to the nature of the study it was not designed to answer questions about cost and quality. “Many other variables that could affect physician behavior could not be examined in this study, including having a sicker patient population, level of physician training, approach to defensive medicine, and, importantly, financial arrangements.”

 The EMR is a technology that compels change and as long as it is resisted, its potential will remain muted.

Source: http://curemd.wordpress.com/2012/05/30/emr-the-untold-story/

Top 5 Benefits of Deploying Patient Portal

Patient PortalIn today’s health care industry, Electronic Medical Records (EMR) with Patient Portals have become the need of the hour for many forward thinking medical practices. EHRs allow health care organizations to improve outcomes by providing proficient medical service, while patient portals typically provide communication services between patients and providers – substantially improving patient satisfaction and the value of services delivered by medical practices.

Key Benefits of Deploying Patient Portal
The advantages of deploying a patient portal are as follows:
  • Simplified administrative and operational processes through instant online access to personal healthcare content
  • Constant access to personal health information empowers patients to be proactive in managing their conditions
  • Improved disease management with automated, condition-specific messages, email reminders and alerts
  • Enhanced patient safety through detailed medication instructions, alerts, warnings and recalls
  • Lab results, radiology reports and procedure information is accessible from anywhere at anytime
These features can be prioritized based on patient needs, resource implications and organizational goals. Online medication renewals, referral requests and basic scheduling require moderate resource commitments from operations, and can easily replace less efficient processes.

A patient portal delivers vital care information directly to the patient’s desktop to help enhance customer satisfaction, eliminate preventable errors along with better care collaboration between doctors and patients.
The real-time collaboration between patients, providers and referring physicians through the patient portal allows clinicians and their patients to share healthcare information in a highly secure, HIPAA compliant environment through the use of SSL and access control patterns whilst, patient access is also typically validated with a user name and password.

Patient portals are also a key tool for physicians to meet “Meaningful Use” requirements and receive federal incentive checks, especially for providing health information to patients. Popular patient portal applications enable patients to register and complete forms online, which can streamline visits to physician clinics and hospitals.

Patient PortalAt present, individual health information is located primarily on paper. However, it is predicted that more than 75% of hospitals around the country will be utilizing this technology by the end of 2014. It is also validated through research that that the usage of patient portals will bring huge benefits with regards to patient safety and the secure exchange of healthcare information.