MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'incentive'. Sat, 03 Sep 2011 02:57:34 +0100 http://www.medworm.com/index.php?rid=5174703&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2Fg_faMvFVu7k%2F Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts. A great deal of work, discussion, and debate by the HIT Policy Committee and its Workgroup members went into developing the recommendations for meaningful use Stage 2 (discussed in the last two Meaningful Use Monday posts). Meetings were frequent and lengthy, but I tried to listen in on most of them to gain some insights into the thinking behind the decisions being made and the future direction of me... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5174703 Mon, 29 Aug 2011 17:35:33 +0100 5174703 http://www.medworm.com/index.php?rid=5159280&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FTRWtDdOJM_4%2F Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts. In addition to the Meaningful Use Stage 2 recommendations discussed in last week’s Meaningful Use Monday, the HIT Policy Committee proposed a new framework for the reporting of clinical quality measures that was designed by its specifically-tasked Quality Measure Workgroup. The recommended concept is depicted in the graphic below—the intention is to broaden the scope of reporting to address a wid... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5159280 Mon, 22 Aug 2011 15:19:08 +0100 5159280 http://www.medworm.com/index.php?rid=5130856&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F7izZd7JZcgo%2F Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts. A few weeks ago, the HIT Policy Committee forwarded its Stage 2 meaningful use recommendations to CMS. CMS is expected to issue a Proposed Rule in early 2012 and the Final Rule in mid-2012.  The first recommendation—intensely debated, but overwhelmingly supported in the end—is to delay the start of Stage 2 until 2014, recognizing the unrealistic time pressure that vendors and providers would fac... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5130856 Mon, 15 Aug 2011 16:43:35 +0100 5130856 http://www.medworm.com/index.php?rid=5118748&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FjLM8hRYzQbY%2F Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts. At last week’s HIT Policy Committee meeting, Robert Tagalicod, (the new director of the Office of E-Health Standards & Services), presented an analysis of the attestation experience to-date [See John's previous Meaningful Use Details post for the slides and report]. The results lend themselves to some interesting observations—admittedly preliminary findings, but revealing nonetheless:  The ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5118748 Mon, 08 Aug 2011 18:58:10 +0100 5118748 http://www.medworm.com/index.php?rid=5107647&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2011%2F08%2F05%2Fpreliminary-meaningful-use-details-out%2F Brian Ahier has a great post up that had the presentation and report (embedded below) that CMS provided to the HIT Policy Committee. It has a lot of great information worth talking about. I’m going to embed the presentation and report below and pull out some of the key points in a post later. Let me know what catches your eye. The CMS Meaningful Use Presentation The CMS Meaningful Use Report Related posts:Meaningful Use Mondays – More 90 Day Reporting Period Details As a follow-up to last week’s Meaningful Use Monday, the... Meaningful Use Measures: Electronic Copy of Health Information – Meaningful Use Monday Meaningful Use Core Measure: More than 50% of all patients... Helpful Meaningful Use Resources – Meaningful Use Monday I spend a lot of my day answering questio... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5107647 Fri, 05 Aug 2011 21:38:20 +0100 5107647 http://www.medworm.com/index.php?rid=5107651&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Flynn%2F2011%2F08%2F01%2Fpublic-health-measures-meet-exclude-or-defer-%25e2%2580%2593-meaningful-use-monday%2F Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts. Last week’s Meaningful Use Monday identified the two meaningful use public health measures—electronic reporting of immunizations and electronic reporting of syndromic surveillance data—at least one of which EPs must include among their 5 menu measures. So, what do you do if you can’t meet one or both of the public health measures?  The requirement: EPs must accomplish at least one of these m... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5107651 Mon, 01 Aug 2011 17:15:34 +0100 5107651 http://www.medworm.com/index.php?rid=5077816&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2011%2F07%2F27%2Femr-and-meaningful-use-books%2F I must admit that I’m not much of a book guy. Especially since there’s so much free information available on the internet about just about any subject you could want. However, I’ve been quite intrigued by the number of healthcare IT related books that I’ve seen coming out of late. Here’s a quick roundup of some of the ones I’ve seen. Getting to Meaningful Use and Beyond: A Guide for IT Staff in Health Care by Fred Trotter and David Uhlman – I’ve been a big fan of Fred Trotter for a while. So, I’m glad he’s working on this book. Turns out the book isn’t even published, but in Fred Trotter open source style fashion, the book is available for free online right now. Of course, they’re hoping you’ll provide feedback. ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5077816 Wed, 27 Jul 2011 18:46:01 +0100 5077816 http://www.medworm.com/index.php?rid=5069569&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2Fb5hGRxrAh3o%2F Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts. When selecting the 5 meaningful use menu measures on which to report—from the list of 10 possibilities—the only constraint is that the EP must include at least one of the two measures from the “public health” category: Perform a test of the EHR’s capacity to submit electronic data to immunization registries Perform a test of the EHR’s capacity to report electronic syndromic surveillance ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5069569 Mon, 25 Jul 2011 15:46:09 +0100 5069569 http://www.medworm.com/index.php?rid=5062328&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Flynn%2F2011%2F07%2F18%2Fmeaningful-use-measures-timely-electronic-access-to-health-information-%25e2%2580%2593-meaningful-use-monday%2F Meaningful Use Menu Measure: At least 10% of all unique patients seen by the eligible professional (EP) are provided timely (available to the patient within 4 business days) electronic access to their health information. This is a third meaningful use measure related to providing patients with access to their health information. Meaningful Use Mondays has already addressed the two core measures—clinical summary and electronic copy of health information—“timely access” is a menu measure.  The requirements are as follows: The measure includes a provision for EPs to claim an exclusion, but I don’t believe that many will qualify for this exclusion. They would have to attest that they “neither order nor create lab tests or information that would be contained in the problem list, m... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5062328 Mon, 18 Jul 2011 15:31:41 +0100 5062328 http://www.medworm.com/index.php?rid=5028543&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FHhgUwFu7e1U%2F Meaningful Use Core Measure: More than 50% of all patients who request an electronic copy of their health information are provided it within 3 business days. Exclusion: Any EP who receives no requests for this information in electronic format.  This measure is distinguished from  the clinical summary measure, (discussed in the previous Meaningful Use Monday post), in two major ways: 1)      “Electronic copy of health information” covers all health information that the provider has regarding the patient, whereas the “clinical summary” is a snapshot of a particular visit. 2)      This measure is driven by requests made by patients or their agents—electronic access must be provided in response to at least 50% of the specific requests received by a provider. By contrast, ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5028543 Mon, 11 Jul 2011 14:18:26 +0100 5028543 http://www.medworm.com/index.php?rid=4997648&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2Fq_tng8IQnxo%2F HITECH Answers has just released the 3rd edition of Jim Tate’s The Incentive Roadmap® The Meaningful Use of Certified Technology: Stage 1 A Manual for Medical Practices. Version 3.0 of the manual that has been helping practices, consultants and vendors across the country understand the step-by-step process of achieving meaningful use is now available. Written by Jim Tate, a nationally recognized expert on the CMS EHR Incentive Program, certified technology and Meaningful Use objectives,The Incentive Roadmap® looks at what steps are needed to get ready for meaningful use and is downloaded immediately upon purchase. I consider Jim Tate one of the foremost experts on meaningful use and certified EHR. So, I was excited when he decided to publish a resource on the details of the EHR in... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4997648 Wed, 29 Jun 2011 16:59:38 +0100 4997648 http://www.medworm.com/index.php?rid=4975984&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FjneuVa-B1fM%2F Meaningful Use Core Measure: Provide clinical summaries to patients for more than 50% of all office visits within 3 business days. Exclusion: Any EP who has no office visits during the reporting period. The clinical summary provides clinical information associated with a specific recent visit. (It does not encompass the entire patient chart.) This measure may appear daunting upon first reading of the requirements, but the guidance below should make it achievable.  The clinical summary can be delivered by one of two means: electronic media, (e.g., patient portal, secure e-mail, CD or USB fob), or a printed copy. According to advice received from CMS, the easiest way for a physician to meet this measure is to employ a patient portal as the default option. Following each office visit, the EP... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4975984 Mon, 27 Jun 2011 16:21:40 +0100 4975984 http://www.medworm.com/index.php?rid=4953043&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FFmpmcaEqcC4%2F Smoking is a major and costly health problem. Because it is such a high priority for CMS, smoking is addressed in the Stage 1 meaningful use requirements by three distinct measures, which has caused a fair amount of confusion. I will try to clarify. The first is a core meaningful use measure. Therefore, every eligible professional (EP) must satisfy this requirement, unless they can attest to meeting the exclusion. Core Meaningful Use Measure: Record Smoking Status More than 50% of all unique patients 13 years old or older seen by the EP have smoking status recorded as structured data. Exclusion: Any EP who sees no patients 13 years or older. Description: Smoking status must be recorded as one of the following 6 categories: current every day smoker; current some day smoker; former smoker;... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4953043 Mon, 20 Jun 2011 14:34:33 +0100 4953043 http://www.medworm.com/index.php?rid=4953049&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F1TWLSkQ0aF0%2F CMS published a list (pdf) of the first providers who received incentive payments under the Medicare portion of the EHR program. What distinguishes these incentive recipients from those announced in early January—(See “Meaningful Use? Not Yet”)—is that these providers actually had to attest to earning these incentives by demonstrating meaningful use. The earlier recipients received their payments through the Medicaid program, which for the first year’s incentive only requires adoption, implementation, or upgrade of a certified EHR, not meaningful use. There are 320 providers on this first Medicare list. Here’s how the list breaks down: Approximately 40 are hospitals/health care centers. As anticipated, the vast majority of the physicians are primary-care providers—over two-t... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4953049 Mon, 13 Jun 2011 15:23:04 +0100 4953049 http://www.medworm.com/index.php?rid=4921556&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Flynn%2F2011%2F06%2F06%2Frelief-may-be-in-sight-for-some-penalty-threatened-eprescribers-%25e2%2580%2593-meaningful-use-monday%2F Some physicians—most notably, surgeons and pain-management specialists—have expressed concern that they will be unfairly subject to the 2012 ePrescribing penalties, based on the fact that their opportunities to ePrescribe are limited by the nature of their practices. The Proposed ePrescribing Rule published in the Federal Register on June 1 offers a potential remedy for these providers.  The rule, which amends the (MIPPA) 2011 ePrescribing rule, affords providers several new arguments they can use to request a “hardship exemption” from the 2012 penalties. (These are in addition to the already existing reasons, i.e., rural areas that lack high speed internet access and/or rural areas that lack pharmacies that accept ePrescriptions.) The new justifications include:       1)  ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4921556 Mon, 06 Jun 2011 17:35:42 +0100 4921556 http://www.medworm.com/index.php?rid=4862667&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FYQ5fIAlOYqg%2F The fact that the CMS FAQ website contains 7 questions on clinical quality measure (CQM) reporting is an indication of the confusion surrounding this core meaningful use measure. Many specialists are concerned that very few, or none, of the CQMs are relevant to their practices. According to FAQ #10144, “In the event that none of the 44 clinical quality measures applies to an EP’s patient population, the EP is still required to report [but with] a zero for the denominators.” It would be logical, therefore, for physicians to conclude that they should report a zero denominator for quality measures related to problems or conditions they do not treat. For the purpose of meaningful use, however, it is not the physician who determines whether a particular quality measure applies—it is... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4862667 Mon, 23 May 2011 17:15:51 +0100 4862667 http://www.medworm.com/index.php?rid=4852975&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2011%2F05%2F20%2Feffect-of-emr-stimulus-money-flowing%2F Yesterday on EMR News, we posted about the first case I’ve seen where someone has collected EHR stimulus money after attesting to meaningful use. It’s the day many have been waiting for. The first checks arrive for those showing meaningful use of a certified EHR (Medicaid had sent some EHR Stimulus checks previously). Yes, the government really is going to pay out the money. Yes, people really are getting paid. In fact, it seems that they’ve pretty much stuck to their schedule for meaningful use stage 1 and paying out the first EHR stimulus checks. Props to the people at CMS and ONC for being able to stick to that schedule (even if meaningful use stage 2 might be delayed). I do have to say that an electronic bank transfer isn’t nearly as exciting as a check in the m... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4852975 Fri, 20 May 2011 22:15:54 +0100 4852975 http://www.medworm.com/index.php?rid=4841660&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Flynn%2F2011%2F05%2F16%2Fhelpful-meaningful-use-resources-%25e2%2580%2593-meaningful-use-monday%2F I spend a lot of my day answering questions about the EHR incentives from SRS clients and also from users of other EHRs. The questions range from extremely basic ones posed by people who are dazed and intimidated by the scope of the program to nuanced questions from those already knee-deep in meaningful use. Since I began writing Meaningful Use Monday, the resources on the subject have grown in number and specificity. Here are a few that physicians and administrators have found helpful recently: Participate in a CMS Provider Call. There is one scheduled for this Thursday (5/19) at 2:30 PM Eastern Time. After the presentation, you will have an opportunity to ask questions and have them answered directly by CMS staffers. To register, click here. The Attestation Users Guide not only provides... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4841660 Mon, 16 May 2011 17:06:04 +0100 4841660 http://www.medworm.com/index.php?rid=4803273&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FVGd_tZ72_Pg%2F To follow up on The “All 3” Vital Signs Dilemma and the posted comments, I want to provide some clarification regarding the vital signs measure and correct some common misconceptions about the requirements:  Meaningful Use Core Measure: Record Vital Signs For more than 50% of all unique patients age 2 and over seen by the EP, height, weight, and blood pressure are recorded as structured data.  The Exclusion: A physician who does not currently track height, weight, and blood pressure does not have to start taking vital signs solely for the purpose of meeting meaningful use. The point I made in last week’s post was that the exclusion may be difficult for some providers to take advantage of due to the “all 3” requirement—but it is available for those who attest that “all 3 vi... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4803273 Mon, 09 May 2011 16:18:48 +0100 4803273 http://www.medworm.com/index.php?rid=4794929&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2Frl9A2MkdeFU%2F My last meaningful use interview went over so well, that I decided that I should do some more. When I saw the news that a GE Centricity customer met meaningful use, I decided that would be a good opportunity for my next meaningful use interview. I’m certainly interested in doing more interviews from a variety of EMR vendors, specialties, and regions. I’d be happy to interview someone who’s deciding to wait or to forgo meaningful use completely. If you are a doctor or practice manager interested in being interviewed, just drop me a note on the EMR and HIPAA contact us page. Now some background on Barbara Watkins and HVCA. Heart & Vascular Center of Arizona (HVCA) Administrator Barbara Watkins, R.N., helped lead the practice’s six cardiologists through the process of... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4794929 Wed, 04 May 2011 17:40:45 +0100 4794929 http://www.medworm.com/index.php?rid=4789379&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Flynn%2F2011%2F05%2F02%2Fmeaningful-use-measures-the-%25e2%2580%259call-3%25e2%2580%259d-vital-signs-dilemma-meaningful-use-monday%2F How does a physician meet this measure if only one or two, but not all three, of the vital signs are a routine part of their practice? This is an issue on which I have sought clarification since before my first Meaningful Use Monday post.  The question has now been asked frequently enough to warrant a formal answer on the CMS FAQ site—and the answer is problematic. Meaningful Use Core Measure: Record Vital Signs For more than 50% of all unique patients age 2 and over seen by the EP, height, weight, and blood pressure are recorded as structured data. Exclusion: Any EP who either sees no patients 2 years or older or who believes that all 3 vital signs of height, weight, and blood pressure of their patients have no relevance to their scope of practice. You’d think this measure would be... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4789379 Mon, 02 May 2011 18:08:44 +0100 4789379 http://www.medworm.com/index.php?rid=4789383&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2011%2F04%2F27%2Fmeaningful-use-medicaid-overview%2F A regular reader of EMR and HIPAA, Wes Kemp, sent me an interesting set of slides/PDF file that gives a meaningful use overview from a Medicaid perspective. I always transgress Medicaid when it comes to meaningful use and the EHR incentive money. Plus, I thought he had an interesting way of displaying the meaningful use overview. Since I hate PDF’s, I did it as an embedded document below. For best viewing, click on the Full Screen button, or you can always download it as well. var docstoc_docid="78110108";var docstoc_title="Meaningful Use Medicaid Overview";var docstoc_urltitle="Meaningful Use Medicaid Overview"; Related posts:Meaningful Use Mondays – Participation Under Medicare vs. Medicaid Physicians who are eligible for both programs will likely find... Meaningful Use Mon... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4789383 Wed, 27 Apr 2011 16:50:54 +0100 4789383 http://www.medworm.com/index.php?rid=4753798&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F0KFMueXj3ss%2F CPOE (Computerized Provider Order Entry), is the direct entering of orders into a computer (or mobile device), so that the order is documented in a digital, structured, and computable format. Meaningful Use Core Measure: CPOE More than 30% of unique patients with at least one medication in their medication list seen by the EP have at least one medication order entered using CPOE. Exclusion: providers who write fewer than 100 prescriptions during the reporting period. CPOE is one of the measures that elicited quite an animated response from the provider community. When initially proposed, this measure required 80% of all orders to be directly entered by the provider. To overcome objections to the scope of the requirement and the burden it would impose, CMS ultimately limited the measure to ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4753798 Mon, 25 Apr 2011 15:41:02 +0100 4753798 http://www.medworm.com/index.php?rid=4753799&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FjBXbmtWKn1I%2F You know on the weekends I love to through in a little round up of some interesting things said about healthcare IT, EMR and other topics on Twitter. Hopefully, they’ll educate, entertain and inform. If not, tomorrow’s another edition of Meaningful Use Monday. #bbpBox_62326577878417408 a { text-decoration:none; color:#A08574; }#bbpBox_62326577878417408 a:hover { text-decoration:underline; } T2: I used to read 4 newsletters, now I don’t. I’ve chg’d to read tweets & blog post – so much more current. #hcsm April 24, 2011 6:26 pm via TweetDeckReplyRetweetFavorite @Colin_Hung Colin Hung I’ve been talking about this quite a bit lately on this blog (see my post about social media EMR information). However, I love how the described their shift... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4753799 Mon, 25 Apr 2011 06:49:58 +0100 4753799 http://www.medworm.com/index.php?rid=4747725&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2011%2F04%2F19%2Finterview-with-meaningful-use-physician-23%2F Yesterday morning, River Falls Medical Clinic (RFMC) of River Falls, Wisconsin, attested for Meaningful Use at 7:30 a.m. CT. The clinic was one of the very first – in fact, #23 to attest to meaningful use under the Medicare program. The following is an email interview I did with Dr. Tashjian about RFMC’s experience in the meaningful use attestation process. Christopher H. Tashjian, MD is the president of River Falls, Ellsworth & Spring Valley Medical Clinics in Wisconsin. The three clinics provide primary care services as well as specialty consults. How long have you been using EMR? Which EMR do you use? River Falls Medical Clinic, RFMC, implemented Cerner’s Ambulatory EHR in March of 2010 after several years of working with Cerner’s PWPM solution. Did you have to upgrade ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4747725 Tue, 19 Apr 2011 22:44:16 +0100 4747725 http://www.medworm.com/index.php?rid=4747726&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2011%2F04%2F18%2Fmeaningful-use-measures-eprescribing-meaningful-use-monday%2F I hope that by now, readers have heeded the advice I gave in a previous post, “No Matter What Else You Do in 2011, You’ve Got to ePrescribe” and are covering their bases regarding ePrescribing under MIPPA. Even though providers can’t collect a meaningful use incentive (as a Medicare participant) during the same year that they earn an ePrescribing incentive, having the ePrescribing workflow in place for MIPPA purposes will prepare them well for meaningful use. Meaningful Use Core Measure: ePrescribing More than 40% of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology. This is a core, i.e., required, measure that can only be excluded by an EP who writes fewer than 100 prescriptions during the reporting period and attests t... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4747726 Mon, 18 Apr 2011 15:21:48 +0100 4747726 http://www.medworm.com/index.php?rid=4747728&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2011%2F04%2F14%2Fehr-qa-is-emr-or-ehr-a-requirement%2F Brenda asked: As a private OT clinic that does not contract with medicare/ medicaid, are we required to use electronic medical records? We do submit claims to private insurance companies electronically. Answer: The short answer is no. In fact, NO ONE is REQUIRED to use EMR whether they take Medicare or Medicaid. However, if you take Medicare or Medicaid, then you have to be a “meaningful use” of a “certified EHR” in order to: 1. Get the EHR Incentive money and 2. Avoid the government penalties for not being a meaningful user of an EHR. Some might argue that the work to show meaningful use is not worth the effort compared to the incentive money you receive. Plus, the penalties for not using an EHR are not that big of an issue (see this post on the EMR penalties ) Alt... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4747728 Thu, 14 Apr 2011 16:45:28 +0100 4747728 http://www.medworm.com/index.php?rid=4676901&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FFMimjQqrNlc%2F In response to strong lobbying activity and numerous comments from physicians, the Final Rule on Meaningful Use (Stage 1) included a provision for physicians to exclude certain measures that are outside the scope of their practice. This was primarily an accommodation made to enable specialists to participate in the EHR incentives program without substantially changing their practices—although some primary care physicians may find exclusions applicable to them as well. For a physician to exclude a measure: The measure must be explicitly identified as “excludable” in the Final Rule—not all measures contain such a provision. (6 core and 7 menu measures are potentially excludable, but for some there will be very few providers who would meet the criteria.) The physician must me... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4676901 Mon, 04 Apr 2011 15:10:29 +0100 4676901 http://www.medworm.com/index.php?rid=4658433&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FS1b-P48WvTY%2F Chris asked the following question: Do modular certified EMR’s qualify for meaningful use and also qualify for full incentive payouts? Answer: Modular certified EHR software can qualify for meaningful use and the EHR incentive payouts. Although, they can’t do it on their own. Although, if you combine the modular certified EHR with other modular or full certified EHR software, then you can qualify. Clear as mud huh? The good thing is that you can go to the ONC CHPL website and select the certified EHR software which you use and it will tell you if combined it meets the criteria. So, for example, maybe you have a modularly certified EHR that is certified for everything but ePrescribing. You could then also purchase a certified ePrescribing software and together they would be considered a... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4658433 Wed, 30 Mar 2011 21:24:25 +0100 4658433 http://www.medworm.com/index.php?rid=4653413&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2Fy_6pmqwP78o%2F John requested that the next series of Meaningful Use Monday posts explore the ins and outs of the individual meaningful use measures. To begin this process, today’s post reviews the basic requirements and the type of information that providers will report. Next Monday’s post will address the options available to some providers to exclude certain measures. Following that, I will address the measures, one by one, week by week (…although I can’t promise that I won’t digress as subjects of timely interest arise!) By now, most people interested in meaningful use know that there are 25 measures and that they are divided into two sets—Core and Menu. Providers must meet all 15 of the core measures and any 5 of the 10 menu set measures, as long as one public health measure is included.... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4653413 Mon, 28 Mar 2011 17:10:12 +0100 4653413 http://www.medworm.com/index.php?rid=4622327&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Flynn%2F2011%2F03%2F21%2Fcms-registration-portal-efficiencies-coming-meaningful-use-monday%2F Registration and attestation are detailed processes which will demand a significant amount of physicians’ time. During a CMS/ONC session at HIMSS, an audience member asked whether each of her organization’s 800 physicians had to personally go onto the CMS portal and register individually. In response to the answer “yes”, she suggested that CMS should at least allow physicians to assign a “proxy” to an administrative staff member to complete the registration process on their behalf. I am happy to report that such a process is in the planning stages for both registration and attestation, (at least for participants in the Medicare program), according to a recently posted FAQ on the CMS website—but physicians will have to wait until at least May to take advantage of it. Physician... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4622327 Mon, 21 Mar 2011 15:14:11 +0100 4622327 http://www.medworm.com/index.php?rid=4605904&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2Fg_FIw5S9j1E%2F I have a number of doctor friends that I know from church, scouts (yes, I’m an assistant scoutmaster), or other local group. I must admit that generally our focus is whatever activity is at hand, but every once in a while they or I will bring up the topic of EMR. These types of discussions are especially fascinating because they give a nice insight into a doctor’s perspective from someone who’s not inside the healthcare IT bubble. You know, that bubble where we all know the difference between meaningful use stage 1 and 2, ONC-ATCB and CCHIT, and a whole set of other acronyms. Certainly these doctors know some of these terms or have at least heard of some of these terms, but they definitely don’t know all the details. In fact, that’s what makes it so interestin... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4605904 Tue, 15 Mar 2011 16:10:24 +0100 4605904 http://www.medworm.com/index.php?rid=4600631&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Flynn%2F2011%2F03%2F14%2Fmeaningful-use-monday-how-will-you-actually-get-your-meaningful-use-money%2F There is a great deal of skepticism about when EHR incentives will be paid and how providers will actually get their money. This is not surprising, given the negative early experiences with the PQRI program and the fact that ePrescribing providers are having to wait until September or October to receive their bonuses for the prior year for the MIPPA incentive program. The good news is that CMS is promising to distribute the first EHR incentives in May, following successful attestations of meaningful use for the initial 90-day reporting period. So how will this happen? A common misconception is that the first year incentives are automatically $18,000. According to the legislation, the incentives are earned at a rate of 75% of Medicare Part B FFS Allowable Charges up to the maximum, (i.e., $... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4600631 Mon, 14 Mar 2011 15:06:31 +0100 4600631 http://www.medworm.com/index.php?rid=4600632&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2011%2F03%2F13%2Funbiased-targeted-and-useful-resources-for-doctors-evaluating-emr-systems%2F I got the following email from a reader of EMR and HIPAA which really hit me when it comes to providing the right resources for medical practices that are researching and implementing an EMR system in their practice. I remember achieving a feeling of solace after discovering your site. When initially researching and realizing how much misleading information is out there, it’s very overwhelming and leaves the researcher of a very important IT addition to a medical practice feeling very alone. Your transparent and no bones about it approach (whether positive or negative) is appreciated by many. Don’t ever change. While I definitely appreciate and am flattered by this reader’s nice comments, I was struck even more by their description of the challenge a medical practice has in findi... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4600632 Mon, 14 Mar 2011 06:24:33 +0100 4600632 http://www.medworm.com/index.php?rid=4600633&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2011%2F03%2F11%2Fmisleading-meaningful-use-marketing%2F In one of my recent discussions with a reader of EMR and HIPAA, they said they loved this site because I don’t have any agenda. Then, they quickly clarified, your only agenda is to have transparency in the process. Your agenda is to bring to light all the information related to a certain topic so that doctors can make an informed decision. I think this reader hit it right on the head. I really don’t have an agenda. I’m generally pro-EHR, but I understand doctors misgivings on why they’re concerned about doing it. Although, I am completely fanatical about having transparency and good information (both good and bad) about the EMR and EHR process. That’s why I get all worked up when EMR advertising or EMR sales people provide misleading information. In fact, I ha... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4600633 Fri, 11 Mar 2011 17:42:35 +0100 4600633 http://www.medworm.com/index.php?rid=4592495&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F2EnzMOvb5bM%2F I have a number of doctor friends that I know from church, scouts (yes, I’m an assistant scoutmaster), or other local group. I must admit that generally our focus is whatever activity is at hand, but every once in a while they or I will bring up the topic of EMR. These types of discussions are especially fascinating because they give a nice insight into a doctor’s perspective from someone who’s not inside the healthcare IT bubble. You know, that bubble where we all know the difference between meaningful use stage 1 and 2, ONC-ATCB and CCHIT, and a whole set of other acronyms. Certainly these doctors know some of these terms or have at least heard of some of these terms, but they definitely don’t know all the details. In fact, that’s what makes it so interestin... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4592495 Thu, 10 Mar 2011 02:10:24 +0100 4592495 http://www.medworm.com/index.php?rid=4560274&cid=t_416522_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fadvice-from-the-emr-trenches%2F2011.03.07 The latest from moi: “Implementing Electronic Medical Records: Advice from the Trenches” in the March/April 2011 issue of HIT Exchange magazine. An excerpt: The news released in late December from the Centers for Disease Control and Prevention that more than half of the nation’s physicians are now using electronic medical records (EMR)—double the adoption rate of just five years ago—is surely worth celebrating. Until, that is, you take a look and realize that just a fourth of office-based physicians have access to a “basic” EMR system including patient history, demographics, problem lists, clinical notes, and computerized physician order entry (CPOE), while just one in 10 has a “fully functional” system, which also includes the communication system required for me... Better Health blogs http://www.medworm.com/rss/comments.php?id=4560274 Mon, 07 Mar 2011 23:00:00 +0100 4560274 http://www.medworm.com/index.php?rid=4566180&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Flynn%2F2011%2F03%2F07%2Fmeaningful-use-not-yet%2F At the recent HIMSS annual conference, many statistics were released touting the early success of the EHR incentives/meaningful use program: 21,000 providers have registered, with many more having indicated their intention to do so. 62 Regional Extension Centers have enrolled 47,000 primary care physicians. 6 certification bodies (ATCBs) have certified 415 EHRs and modules. $20 million in incentives has already been paid to 25 providers (including hospitals) in 4 states. Does this mean that anyone has successfully demonstrated meaningful use? Not yet. The incentives were awarded by the first Medicaid programs for the “adoption, implementation, or upgrade” (A/I/U) of certified EHR technology—a Medicaid-only provision for first-year incentives. The first demonstrations of... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4566180 Mon, 07 Mar 2011 15:05:25 +0100 4566180 http://www.medworm.com/index.php?rid=4566181&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2011%2F03%2F06%2Fstimulus-money-poll-and-phr-use-results%2F Last week I posted a poll asking how many readers of EMR and HIPAA used a PHR. Here’s the results of the PHR poll: Pretty interesting to see that about 77% of those voting have not started a PHR or started one, but didn’t add much to their PHR. I guess I’m not all that surprised since I fall into that category as well. The scary thing is that this is coming from people who are in the healthcare and healthcare IT industry. If we’re not using a PHR, then I’d imagine that the number of PHR users outside of the industry is even smaller. I’m still considering the compelling PHR use case since the results from this PHR poll says that one hasn’t shown its face yet. However, I must admit that the more I research and read about PHR and some of the possibil... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4566181 Mon, 07 Mar 2011 07:20:30 +0100 4566181 http://www.medworm.com/index.php?rid=4536162&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FGcqZUnpYrM0%2F A lot of people like to throw around a lot of market share numbers for EMR and EHR adoption. One thing that’s clear in pretty much every number I’ve seen (and I’ve seen a lot) is that we still have a long way to go. Across all of these numbers there’s also a few other generally accepted principles: -Small practices have a much lower EMR adoption percentage as compared with large practices -Specialists have a higher EMR adoption percentage than general medicine doctors -No one knows how to truly define what EMR adoption is in a survey Taking in all my experience reading study after study and also my experience talking with hundreds and thousands of doctors, EMR vendors, consultants, etc about EMR adoption I’d put current EMR adoption somewhere around 25%. This ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4536162 Wed, 02 Mar 2011 00:19:57 +0100 4536162 http://www.medworm.com/index.php?rid=4532282&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FH5NRyC5wBA0%2F The last Meaningful Use Monday post detoured from the EHR incentives to ePrescribing under MIPPA—given its importance based on the impending schedule of penalties. Because I receive ePrescribing questions on a daily basis, I thought a quick recap of ePrescribing basics might be helpful: Incentives and penalties: Year Incentives* Penalties* 2011 1% – 2012 1% 1%** 2013 0.5% 1.5%** 2014 on – 2% *Percent of provider’s total Medicare Part B FFS Allowable Charges. (Incentives assume provider does not receive EHR incentive for that year.) **Based on 2011 ePrescribing activity Incentives are earned per provider, and each provider must individually meet the requirements. This means that some providers within a practice might qualify for an incentive, while o... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4532282 Mon, 28 Feb 2011 15:58:42 +0100 4532282 http://www.medworm.com/index.php?rid=4512393&cid=t_416522_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnew-doctor-considering-primary-care-show-me-the-money%2F2011.02.23 There are plenty of reasons why medical students aren’t choosing primary care as careers. Lack of role models. Perception of professional dissatisfaction. High burnout rate among generalist doctors. Long, uncontrollable hours. But what about salary? Until now, the wage disparity between primary care doctors and specialists has only been an assumed reason; the evidence was largely circumstantial. After all, the average medical school debt exceeds $160,000, so why not go into a specialty that pays several times more, with better hours? Thanks to Robert Centor, there’s a study published in Medscape that shows how money affects career choice among medical students. Here’s what they found: Sixty-six percent of students did not apply for a primary care residency. Of these, 30 percent woul... Better Health blogs http://www.medworm.com/rss/comments.php?id=4512393 Wed, 23 Feb 2011 18:00:09 +0100 4512393 http://www.medworm.com/index.php?rid=4501651&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F66Ia9bwWS-8%2F In probably the biggest news of the day at HIMSS, we got the following tweet spreading quickly through the Twittersphere: #bbpBox_39359393585700864{background:#9AE4E8 url(http://a3.twimg.com/a/1297983335/images/themes/theme1/bg.png) no-repeat !important;padding:20px;}#bbpBox_39359393585700864 p.bbpTweet{background:#fff;padding:10px 12px 10px 12px !important;margin:0 !important;min-height:48px;color:#333333 !important;font-size:18px !important;line-height:22px;-moz-border-radius:5px;-webkit-border-radius:5px}#bbpBox_39359393585700864 p.bbpTweet a {color:#0084B4 !important}#bbpBox_39359393585700864 p.bbpTweet span.metadata{display:block;width:100%;clear:both;margin-top:8px !important;padding-top:12px !important;height:40px;border-top:1px solid #e6e6e6}#bbpBox_39359393585700864 p.bbpTweet sp... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4501651 Mon, 21 Feb 2011 03:29:06 +0100 4501651 http://www.medworm.com/index.php?rid=4477869&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FM7bwC-aDYy8%2F No Matter What Else You Do in 2011, You’ve Got to ePrescribe With all of the focus on meeting meaningful use, the requirements related to ePrescribing under the Medicare MIPPA program seem to be getting lost in the shuffle. Just as some practices didn’t get the message about the 2010 change in ePrescribing G-codes until late in the year, I am hearing that the communication hasn’t reached everyone about the importance of ePrescribing in 2011; so I thought I would post a reminder: 2011 ePrescribing activity will be the basis for the 2012 and 2013 ePrescribing Medicare penalties (AKA “adjustments”) under MIPPA. If you are not already ePrescribing, it’s important to start very soon. The following are the rules: ePrescribe on 10 Medicare encounters between now and June 30, 2011 to ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4477869 Mon, 14 Feb 2011 15:39:08 +0100 4477869 http://www.medworm.com/index.php?rid=4445874&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F6yy6VFb9JdI%2F As a follow-up to last week’s Meaningful Use Monday, the following are a few more clarifications related to the 90-day reporting period for a provider’s first payment year: Although the reporting period is tied to the first payment year for a particular provider, the incentives remain attached to the calendar year. The amounts of the incentive payments are specified in ARRA and do not change depending on when a provider chooses to begin demonstrating meaningful use. Providers will be eligible for the maximum total of $44,000 (Medicare) over the 5-year period if their first payment year is either 2011 or 2012. Any continuous 90-day period within the calendar year is acceptable, e.g., January to March, June to August, or October to December—but November to January wo... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4445874 Mon, 07 Feb 2011 17:55:37 +0100 4445874 http://www.medworm.com/index.php?rid=4424300&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FNfqJ8rWZReQ%2F The other day I came across an interview with David Blumenthal. I didn’t find anything all that meaningful in the interview itself. However, in the comments, someone provided some really interesting commentary on what Blumenthal said in the interview. Dr. Blumenthal says we need operability before we move to interoperability. Yet if you don’t design your systems from the start to interoperate, you’ll inevitably wind up with operable systems that do not interoperate – at all. Having accomplished this, we’ll then have to develop and impose an after-the-fact standard to which all systems must comply. This will mean redesign, retrofit, and plastering all kinds of middleware layers between disparate systems. It may even result in retraining tomorrow all those provi... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4424300 Tue, 01 Feb 2011 17:12:03 +0100 4424300 http://www.medworm.com/index.php?rid=4419241&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FLdTHjmSNF9c%2F I receive many questions about the 90-day reporting period and skepticism about whether the provision applies to years beyond 2011. To clarify: The reporting period is 90 days as long as it is the first payment year for that particular provider—whether that year is 2011, 2012, 2013, or even 2014. People frequently ask me for documentation of the above, so I am providing it here. The following citations are from the Final Rule in the Federal Register: “We are finalizing the 90-day reporting period for the first payment year based on meaningful use as proposed for Medicare EPs, eligible hospitals and CAHs and full year EHR reporting periods for subsequent payment years.” – page 44320. “The first payment year for EPs is any calendar year (CY) beginning with CY 2011 and ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4419241 Mon, 31 Jan 2011 17:54:02 +0100 4419241 http://www.medworm.com/index.php?rid=4394556&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FuNX8RvC5mP0%2F To successfully demonstrate meaningful use, providers must report on all patients, regardless of payer. The government describes the program as “payer-neutral” as it applies to patients. Even though providers elect to pursue incentives under either Medicare or Medicaid, they must meaningfully use their EHR in the same manner, and report the same data, for their entire patient population—private and self-pay patients, as well as those who are government-insured. While the descriptions of many of the meaningful use measures define their respective numerators and denominators as a subset of the provider’s patients, these distinctions are based on factors totally independent of payer status. It is interesting that the government can impose requirements related to patients for whom it i... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4394556 Mon, 24 Jan 2011 17:23:22 +0100 4394556 http://www.medworm.com/index.php?rid=4361099&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FGi9w-tkf70Y%2F To continue last Monday’s post regarding the differences between participation under Medicare and Medicaid, the Medicaid program imposes no penalties (or as Medicare euphemistically calls them, “adjustments”) for not being a successful meaningful user. Medicare adjustments are scheduled to begin in 2015. Upon discovering this discrepancy, one (somewhat devious-minded) physician suggested to me that this provided a loophole: declare as a Medicaid participant, begin participating (successfully or unsuccessfully) in 2015, and insulate yourself from any penalties. I’m sorry to report that, as creative as this strategy seemed, non-meaningful use Medicaid participants will still be subject to adjustments to their Medicare fee schedules when those penalties begin. Two other noteworthy dif... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4361099 Mon, 17 Jan 2011 17:09:12 +0100 4361099 http://www.medworm.com/index.php?rid=4338063&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FfQ2PDvN_lFc%2F As expected the first EMR stimulus checks have been issued and we’re starting to learn who the first providers are to receive the checks. There’s even the obligatory big check picture accompanying the coverage of the first EMR stimulus checks. According to a Government Health IT article, University of Kentucky Healthcare received a $2.86 million payment. That’s a nice chunk of change and represents a third of the hospital’s overall expected payment from CMS. I think most hospitals would enjoy a check like that. Of course, what we don’t know is how much University of Kentucky Healthcare spent to purchase and implement their EMR. I’m sure we’ll see those numbers come out as more people get their EMR stimulus checks. The first EMR stimulus checks on t... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4338063 Wed, 12 Jan 2011 19:41:12 +0100 4338063 http://www.medworm.com/index.php?rid=4331080&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FNSpOF3oMI-g%2F Physicians who are eligible for both programs will likely find participation under Medicaid to be a preferable option because the incentives are higher, the first year rewards adoption/purchase, (without requiring demonstration of meaningful use depending on the state); and the program offers more flexibility in terms of time frames. To participate under Medicaid, a provider must have a practice that is 30% Medicaid (20% for pediatricians), based on number of patient encounters (as opposed to revenue). Some providers are only eligible under Medicaid—nurse practitioners; certified nurse-midwives; dentists; and physician assistants who practice in a Federally Qualified Health Center or rural health clinic that is led by a physician assistant. Not all states have their EHR incentive program... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4331080 Mon, 10 Jan 2011 22:57:32 +0100 4331080 http://www.medworm.com/index.php?rid=4318395&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2011%2F01%2F04%2F2011-emr-prognostications-and-predictions%2F While I admit that I’m much more suited to comment on other people’s prognostications and predictions for EMR and health care IT in 2011, I decided to throw caution to the wind and try and make some predictions for the EMR world in 2011. Few EMR Vendor Acquisitions – I predict that acquisitions of EMR vendors will actually slow down in 2011. Certainly there needs to be some EMR company consolidation with 300+ EMR companies out there right now (and it seems more coming every day). However, I think 2011 will be a wait and see period where companies want to see how the various EMR companies perform for their clients interested in getting the EMR incentive money. The only thing that might ruin this prediction is that if many of the 300+ EMR companies have issues selling produ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4318395 Tue, 04 Jan 2011 19:07:37 +0100 4318395 http://www.medworm.com/index.php?rid=4309698&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2Fcw06VxzbBg4%2F Registration for participation in the EHR incentives program begins today. It is done online (no paper registration, appropriately enough!) by using the registration link that should now appear on the CMS Registration and Attestation page. That page details all the information needed, so I will just remind providers who plan to participate under the Medicare program that they will have to be enrolled in PECOS, (Provider Enrollment, Chain and Ownership System)—although not necessarily before they register. While it is a good idea to begin familiarizing yourself with the registration process and requirements, there is no need to feel rushed. Registration does not have to be done immediately—it can even be done at the same time as attestation—and the earliest date that providers can att... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4309698 Mon, 03 Jan 2011 18:08:50 +0100 4309698 http://www.medworm.com/index.php?rid=4298689&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FEaXwhFuiM7w%2F I’m excited to announce the beginning of Meaningful Use Monday on EMR and HIPAA. I first came up with the idea when Lynn Scheps from SRSsoft commented on one of my previous meaningful use posts. Lynn provided such valuable information, I asked her if she’d be interested in becoming a regular guest blogger on EMR and HIPAA. As they say, the rest is history. Each Monday, Lynn (and sometimes myself) will be covering some topic related to the EMR Stimulus money and meaningful use. We hope you enjoy Meaningful Use Monday. -John With the impending start of the EHR incentive program on January 1, the results of a recent Health Data Management poll are troublesome. 72% of respondents feel that the meaningful use guidance provided by the government to-date has been either “inadequate ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4298689 Mon, 27 Dec 2010 19:18:40 +0100 4298689 http://www.medworm.com/index.php?rid=4251164&cid=t_416522_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2010%2F12%2F07%2Fmore-meaningful-use-clarifications-and-maximizing-ehr-arra-and-eprescribing-mipaa-incentives%2F I love the smart readers from this site. They always keep me in line and do a good job clarifying the details of meaningful use for me and you. A few such comments were made on my years for meaningful use post. I thought they were worth sharing since I know that many of you don’t go back and read the great comments people make on my posts (I’ll forgive you for now). Lynn Scheps from SRSsoft wrote the following comment about a benefit to not showing meaningful use in 2011 and electing to wait until 2012. It’s a way to maximize your incentive money. Although, you will need to implement your EHR quickly to maximize them. Here’s Lynn’s comment: There is an additional benefit to electing 2012, instead of 2011, as an EP’s first EHR incentive payment year (an unint... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4251164 Tue, 07 Dec 2010 18:58:27 +0100 4251164 http://www.medworm.com/index.php?rid=4151792&cid=t_416522_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhen-doctors-are-paid-less-unnecessary-prescriptions-drop%2F2010.11.09 Take medical uncertainty. Add financial incentive to treat. Voila! Increased utilization. Now take away financial incentive to treat. Guess what you get? MedPageToday explains, in the case of hormone therapy for prostate cancer: Medicare accomplished what clinical guidelines and evidence-based medicine couldn’t: it reduced unnecessary use of androgen deprivation therapy (ADT) in prostate cancer. Inappropriate use decreased by almost 30% from 2003 to 2005, following enactment of the Medicare Modernization Act, which lowered physician reimbursement for ADT. Appropriate use of ADT did not change during the same time period, according to an article in the Nov. 4 issue of the New England Journal of Medicine. “Our findings suggest that reductions in reimbursement may influence the de... Better Health blogs http://www.medworm.com/rss/comments.php?id=4151792 Tue, 09 Nov 2010 19:00:48 +0100 4151792 http://www.medworm.com/index.php?rid=4065460&cid=t_416522_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D58 At about the time when the when the Wright brothers first flew, advanced medical technology consisted of a microscope, an X-ray machine, and a sterilizer.  Now, providers purchase almost $70 Billion worth in high tech Lab, patient monitoring, imaging, IT, radiation therapy, and robotic technology each year.  While gathering background information for one of my papers, I found a common concern facing administrators with the capital budget process, which can be summed up by a comment from Ms. Kim Capps, CFO of Green-Breach Memorial Hospital in Charlotte, MI.  She stated, “Most of the time, we have more requests than we have capital; therefore, we have to set priorities, but how we set priorities varies from year to year.”  Hospitals are then left wondering if there is a more effectiv... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4065460 Wed, 13 Oct 2010 14:15:30 +0100 4065460 http://www.medworm.com/index.php?rid=3733084&cid=t_416522_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fget-a-discount-if-your-doctor-is-running-late%2F2010.07.07 Should doctors face consequences if they run late? From The New York Times’ health blog, Well, comes a story where a medical group promises “same-day appointments and longer, more personalized visits that start on time.” Sounds good, right? But it comes with a caveat, namely, a $199 annual membership fee. A tremendous amount of primary care can be bought with that amount of money, and if patients were willing to pay that, service will most definitely improve. (more…) *This blog post was originally published at KevinMD.com* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3733084 Wed, 07 Jul 2010 23:00:19 +0100 3733084