News 3/21/13

March 20, 2013 News No Comments

The CMS Office of E-Health Standards and Services says that between five and 10 percent of all EPs attesting for MU will be selected for prepayment audits. According to the director of CMS’ Health IT Initiative Group, selections will be made “both randomly and also based on protocols that identify suspicious or anomalous attestation data.”

3-20-2013 10-03-37 AM

McKesson launches two free mobile apps for the iPad and iPhone. Lytec Mobile is for use with the Lytec 2013 practice management system, while Medisoft Mobile is available for Medisoft V18.

Emdeon reports Q4 revenues of $300 million, up six percent from a year ago, and a net loss of $10 million vs. $70 million.

3-20-2013 10-12-07 AM

SiliconMesa partners with DrFirst to provide Rcopia e-prescribing functionality to customers running the SiliconMesa EHR and PM system.

3-20-2013 10-38-24 AM

The 42-physician Yankton Medical Clinic (SD) selects InteliChart’s patient portal.

CMS hosts a series of Webinars this week and next to advise EPs and practice managers on participation in the EHR incentive program, PQRS, and the e-Rx program. The Webinars will review the actions that EPs need to take in 2013 in order to earn incentives and avoid payment adjustments.

3-20-2013 1-04-44 PM

Please join me in welcoming Nordic Consulting as the newest HIStalk Practice Platinum Sponsor. Last year KLAS ranked Nordic the #1 firm providing Epic staffing and implementation support and it’s one of only four firms to be credentialed for Epic Community Connect. The Madison, WI-based Nordic is the largest Epic-only consulting firm and all  of its 130 consultants are Epic-certified with an average of nine years EMR implementation experience. Nordic consultants have over 800 certifications (an average of four each) and collectively demonstrate expertise on every Epic application. We appreciate Nordic’s support of HIStalk Practice.

3-20-2013 5-18-40 PM

More than half of all hospitals participating in a Jackson Healthcare survey plan to acquire a physician practice this year, which is up from 44 percent last year. Though last year many practices initiated the acquisition process, hospitals also purchased practices to build or maintain a competitive advantage and attract physician recruits.

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News 3/19/13

March 18, 2013 News 1 Comment

3-18-2013 3-51-19 PM

The 48-provider Commonwealth Orthopaedic Centers (KY) chooses SRS EHR and PM.

PCPs and endocrinologists that have electronic access to their patients’ formularies and co-pays are more likely to prescribe a less expensive drug for Type 2 diabetes and hypertension.

3-18-2013 12-32-36 PM

Through February 2013, Medicare and Medicaid have paid an estimated $4.3 billion in MU incentives to 216,000 Eligible Providers. The most often used menu objectives for EPs are drug formularies, immunization registries, and patient lists; the least popular are transition of care summaries and patient reminders.

athenahealth reports that 96 percent of its participating providers have successfully attested for the 2012 Stage 1 Year 1 MU program.

3-18-2013 1-36-25 PM

SRS CEO Evan Steele offers an interesting analysis of MU attestation data as of December 2012, including the observation that many of the 472 EHR vendors with certified Complete EHRs did not have a single physician who had attested by the end of the year. Evan notes that the top 24 EHR vendors account for 80 percent of all attestations and only 32 companies have exceeded 500 attestations. Meanwhile, 112 vendors have had only one to five attestations. Evan’s prediction: many EHR vendors will not be around to see Stage 2.

SuccessEHS successfully moves into production health information exchange with South Carolina’s HIE.

3-18-2013 2-52-24 PM

Hayes Management Consulting updates its Web site to commemorate its 20th year in business.

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Practice Wise 3/15/13

March 15, 2013 Guest articles No Comments

Electronic File Management – Protecting PHI

The final HITECH related HIPAA rule has been published. There is so much more work to be done to protect your practice data. Before you can set policies around how to keep your electronic data safe, you have to fully understand what electronic data you have and what levels of security are necessary for each category.

As I investigate new technologies to help us track and protect electronic PHI, I realize I’m a huge failure at keeping my past New Year’s resolutions. In particular, file maintenance. Back in the days of all paper files, we had an annual ritual of making bankers boxes, cleaning out files, archiving the old, moving forward the new, labeling the boxes, and putting them in storage. You knew exactly what files you were archiving and where they were going to be stored. It was a satisfying exercise, a visual accomplishment. A truck from the secure storage site came and picked up the boxes and we let them manage the security of the PHI in those boxes. Task completed.

We are focused on helping our clients understand the final rule as it relates to managing their electronic data and keeping PHI secure. Most small practices are unaware of where all their data is stored (consider all the desktop and My Documents folders of each user). There are two issues we are focusing on — data storage size and security.

Our first steps are to help the practices decide what to keep and what to discard. Right now for most offices, if it’s scanned, it’s kept. Nobody is going back to look at what is in patient EHR charts or computer/network directory flat files. They are not aware of the growing issues they are creating. We are seeing huge leaps in database sizes as everyone is scanning documents into their EHR and forgetting about them. Nobody is doing document maintenance as far as I can tell.

In the paper days, you thinned your charts. You didn’t keep old copies of registration forms. You didn’t file preliminary lab results when you got finals. The same edict needs to be applied to your electronic charts.

This may not be easy or a desirable task, but here are some thoughts:

  • Review your patients by visit history and clean up charts on all those not seen in the last three years, just like when you pulled charts off the wall by their end tab year stickers. You can also do these tasks on current patient, as you touch their charts.
  • Remove all but the latest registration forms (verify if your EHR tracks changes made in the system so you have historical data if needed.)
  • Remove all preliminary lab result attachments (if your labs are attached as documents and not discrete data elements), leaving only the final results attached.
  • Remove historical patient photos. For instance, if you are a pediatric practice and take photos at different stages in the child’s life, consider getting rid of all but the latest image. Photos are usually the biggest attachment files.
  • If you routinely take photos for clinical purposes (i.e., dermatology), check your image size default on your camera(s) and see if you can use smaller images with satisfactory viewing results.
  • Although it should go without saying, remove anything that doesn’t belong in the chart to begin with.
  • Review your clinic protocols for scanning in charts from other offices. I routinely see clinic staff getting 50-plus page charts from other offices and scanning the entire thing into their EHR. Set a practice-wide protocol of what documents you need from other providers or your previous practice if you have moved. Be concise! You can always call the other office if there is something you need.
  • Be aware of chart custody laws; who is responsible for PHI from external sources that are now a part of your chart records.
  • If you are preparing to go live on EHR, now is the time to think long and hard about what you will scan and attach. I highly recommend using a professional scanning company to handle back scanning of your current paper charts into your new system. They have better scanners than you have in your office, which compress images much smaller than your office scanner. Also, they should be able to help you make critical decisions about what to scan and what to discard in your paper charts. Thin your charts first!
  • Resist the urge to hire a bunch of students to come in and scan charts. They don’t have an understanding of your data, don’t know what to keep, and won’t identify when something is amiss in the chart. The file sizes will be much larger than a professional scanning solution.
  • Look at billing documents you’ve scanned. Apply the same IRS record retention rules you do for paper charts and start removing all those images of EOBs etc. that you no longer need to maintain.
  • For the sake of space, continue to be ruthless in deciding what you keep and what you don’t. If the documentation can be retrieved from another source (insurance company, referring doctor, lab or hospital) let them be the file managers for you when you can.
  • For security, have your staff clean up their Desktop and My Documents directories, get that stuff off the local machines, and especially laptops if they leave the office, and onto a secure drive on your network. Have your IT support turn off group policies that re-direct My Documents directories to the server and teach the end users how to use the shared network drives instead. It’s much easier to secure data when it’s all contained in one place.

Julie McGovern is CEO of Practice Wise, LLC.

News 3/14/13

March 14, 2013 News No Comments

The number of pharmacies accepting e-prescriptions for controlled substances grew from 22 in February 2012 to over 13,000 today, primarily driven by acceptance from drugstore chains CVS, Walgreens, and Rite-Aid. According to DrFirst, 18 percent of all pharmacies now receive e-prescriptions for controlled substances.

Pediatric and family medicine practices that serve children, especially those with five or fewer physicians, are less likely to have the resources required to implement all the NCQA standards for medical home certification, according to a University of Michigan study.

3-13-2013 10-45-39 AM

The 21-physician Kerlan-Jobe Orthopaedic Clinic (CA) selects Orion HealthCorp to provide medical billing and practice management.

CureMD completes its acquisition of Navinet’s EMR and PM provider base. Navinet had been a reseller of CureMD’s solutions.

3-13-2013 11-05-06 AM

Boston Redevelopment Authority Director Peter Meade participated in the formal opening of CareCloud’s Boston office, which is is expected to house 35-40 employees by the end of the year.

Eighty-seven percent of doctors say they receive too many EHR-based alerts, according to a survey of 2,600 primary care physicians.Thirty percent of the providers admit missing some abnormal patient results because they are overwhelmed with an average of 63 alerts per day.

3-13-2013 11-18-41 AM

Advanced Orthopedic Center (FL) selects SRS EHR for its nine physicians.

3-14-2013 6-31-39 AM

Group Health (WA) providers doubled the rate of on-time screenings for colon and rectal cancer using EHRs to identify patients due for screening, according to a study published in Annals of Internal Medicine.

Emdeon begins the process of mapping new HIPAA 6020 standards for CMS and creating an analytical methodology to define the processes and tools required for the transition.

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From the Consultant’s Corner 3/12/13

March 12, 2013 Guest articles No Comments

Bringing the Outside In: Two Ways to Capture External Data in Your Business Intelligence Efforts
By Brad Boyd

The term “business intelligence” has been tossed around for years as a way to describe the process of capturing, analyzing and interpreting data—and then using it to make organizational decisions.

Many of the healthcare organizations I work with have engaged in business intelligence activities for a long time, focusing on collecting and leveraging internal data and information. However, as the industry shifts from volume-based reimbursement to value-based reimbursement, I believe the need for data will shift as well. Moving forward, organizations will discover an exponential increase in their data requirements—not only internal data, but also external data from other healthcare providers, payers, and others.

In my opinion, organizations must figure out how to integrate external data and incorporate it into current business intelligence efforts. The big question is: What’s the best way to do this?

I advise one of two main approaches. The first one involves bringing external data into your organization a little bit at a time. For example, you could import data into distinct buckets within an existing data warehouse, and access that data through a variety of reports. If a clinician, administrator, or other staff person wants to see the data, he or she could ask for a report to review.

Although this approach is cost effective and requires minimal resources to set up, it doesn’t provide a seamless integration between external and internal data. External information is accessible from a segregated reporting perspective, but isn’t available in an integrated way through the EHR or other IT systems.

In fact, the whole process can be rather clunky, given that you could quite possibly have to leave one source of data to view another. In certain situations, this could be very frustrating. In addition, it fails to provide a comprehensive view of both internal and external data.

If this approach seems too time-consuming and cumbersome, I would think about marrying external and internal information upfront, storing them both in IT systems right away. Engaging in this type of wholesale move provides quicker, more streamlined access to comprehensive data for individual and population health management.

However, I have to caution that this avenue is much more costly and resource intensive. It involves updating and reworking your current IT solutions and your business intelligence strategies. Given all of the other competing priorities in your organization—ICD-10 and Meaningful Use, for example—pursuing this type of large-scale integration may not be feasible.

Whether you choose to absorb external data incrementally or all at once, there’s no question in my mind that you will need to gain access to it and share it across your organization. The current healthcare environment demands it.

I highly recommend that all healthcare organizations start seriously thinking about the best ways to incorporate external data into their business intelligence efforts. It’s essential to weigh the pros and cons of different approaches and map out a strategy. Otherwise, you may be left unprepared for the data-enriched, value-based future of healthcare.

Brad Boyd is vice president of sales and marketing for Culbert Healthcare Solutions.

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