EHR Experts

Medical practices that have implemented electronic health record systems report stronger financial performance than those using paper-based systems, according to a report released Monday by the Medical Group Management Association, Health Data Management reports.

Report Details

The report — titled “Electronic Health Records Impacts on Revenue, Costs and Staffing: 2010 Report Based on 2009 Data” — used data from a survey of 1,324 primary care and specialty practice members of MGMA (Goedert, Health Data Management, 10/25).

MGMA said the report relies on voluntary participation and might not be representative of the entire medical practice industry (CMIO, 10/26).

Key Findings

The study found that:

• Independent physician practices with EHR systems had a median of $49,916 greater total revenue after operating costs per full-time physician in 2009 than physician practices using paper-based systems;
• Hospital- or delivery system-owned multispecialty practices with EHR systems had a 2009 median operating margin that was $42,042 higher than such practices that lacked EHRs (Health Data Management, 10/25); and
• After five years of using EHRs, independent physician practices reported a median operating margin that was 10.1% higher than physician practices in their first year of EHR use (Monegain, Healthcare IT News, 10/25).

According to the report, independent physician practices face the highest health IT costs during the first year after EHR implementation, but medical record and transcription costs decrease over the following years (Health Data Management, 10/25).

Source    :     http://www.ihealthbeat.org/articles/2010/10/26/report-ehr-use-has-financial-benefits-for-physician-practices.aspx

Filed under: EHR, Electronic Health Records on November 15th, 2010 | No Comments »

NEW ORLEANS – Medical practices that have implemented an electronic health record system report better financial performance than those that have not, according to the Medical Group Management Association’s newly released “Electronic Health Records Impacts on Revenue, Costs, and Staffing: 2010 Report Based on 2009 Data.”

The suvey was released Oct. 25 at MGMA’s annual meeting in New Orleans.

Practices that were not owned by hospitals or integrated delivery systems reported $49,916 greater total medical revenue after operating cost per full-time-equivalent (FTE) physician (operating margin) than practices with paper medical records. These practices also reported greater expenses ($105,591 per FTE physician) but had $178,907 greater median revenue per FTE physician than practices with paper medical records.

This same pattern can be observed in hospital/IDS-owned practices. Multispecialty practices that were hospital-/IDS-owned and had an EHR reported an operating margin that was $42,042 more than the margin in those with paper medical records.

“Adopting an electronic system can be costly and time consuming, and understanding the impact it will have on the practice is critical,” said William F. Jessee, president and CEO of MGMA. “While the implementation process can be very cumbersome, these data indicate that there are financial benefits to practices that implement an EHR system.”

Practices that are not owned by hospitals or integrated delivery systems also report an increase in financial benefits as they gain more experience with their systems. After five years of EHR use, these practices reported an operating margin 10.1 percent greater than practices in their first year of having an EHR.

The survey report reveals that the highest information technology costs occur in the first year after installation in non hospital/IDS owned practices. Medical records and transcription staff costs decrease after this time.  Information technology staffing per FTE physician increased slightly after five years (0.13 to 0.15), and FTE medical records staff per physician decreased by 44.12 percent (0.34 to 0.19).

“The potential of improved financial performance should be an encouragement for many organizations to purchase and use an EHR,” Jessee said. “Physicians adopting these technologies may also earn up to $44,000 in Medicare EHR incentives funded through the HITECH Act. However, while these incentives can defray some of the implementation costs, qualifying for them by demonstrating ‘meaningful use’ of the EHR is expected to be challenging for many practices.”

MGMA’s mission is to continually improve the performance of medical group practice professionals and the organizations they represent. MGMA promotes the group practice model as the optimal framework for healthcare delivery, assisting group practices in providing efficient, safe, patient-focused and affordable care. MGMA is headquartered in Englewood, Colo., and maintains a government affairs office in Washington, D.C.

Source  :  http://www.healthcareitnews.com/news/electronic-better-paper-bottom-line

Filed under: EHR, EHR companies, Electronic Health Records on November 3rd, 2010 | No Comments »

In an open letter, national health IT czar Dr. David Blumenthal is urging the health IT vendor community to help bolster e-health record adoption rates among healthcare providers in underserved, minority communities.

The letter, co-signed by Blumenthal and Dr. Garth Graham, director of the office of minority health, cited a Centers for Disease Control and Prevention National Ambulatory Medical Care survey indicating that EHR adoption rates “remain lower among providers serving Hispanic or Latino patients who are uninsured or relied upon Medicaid.”

While the HITECH Act of the American Recovery and Reinvestment Act is providing more than $20 billion in federal incentives to encourage the deployment and meaningful use of health IT systems, the letter was written “to solicit your assistance in making sure we are not creating a new form of digital divide.”

The letter said the CDC survey data also shows that “EHR adoption rates among providers of uninsured non-Hispanic Black patients are lower than for providers of privately insured non-Hispanic White patients.”

A CDC National Ambulatory Medical Care report found that in 2005 and 2006, EHR adoption among primary care physicians (PCP) serving privately insured patients was higher than those serving Medicaid patients. EMR adoption rates among PCP serving Medicaid patients was about 8.3%, compared with an adoption rate of 13.2% among primary care doctors serving Medicaid patients.

That study also found that the percentage of Latino or Hispanic Medicaid patients with primary care physicians using EHRs was only 5%, compared with 14% for non-Hispanic White patients who are privately insured.

The use of EHRs can help healthcare providers in the delivery and management of care to patients, including those with chronic conditions. The systems can also bolster decision making by providing clinicians with more comprehensive patient data, as well as help eliminate medical errors and reduce costs associated with unnecessary or redundant tests.

“Racial and ethnic minorities remain disproportionately affected by chronic illnesses, a contributing factor to intolerably high mortality and morbidity rates,” said the letter. “Electronic health records possess the ability to help improve both the quality and efficiency of medical care accessible by minorities, so that perhaps rates of chronic illness, mortality and morbidity decrease within these communities.”

Source   :     http://www.informationweek.com/news/healthcare/leadership/showArticle.jhtml?articleID=227900405&queryText=emr

Filed under: EHR, Electronic Health Records on October 26th, 2010 | No Comments »

NASHVILLE, TN – CCHIT chair Karen Bell says the EHR certification process required for meaningful use is moving steadily in the right direction. “It’s a little bit like the Wild West because things are changing so rapidly,” she said. “But we’re clearly making progress.”

In a keynote speech at the HIMSS Summit of the Southeast in Nashville, Bell highlighted the differences between the CCHIT Certified designation and the certification it now offers as one of just three Authorized Testing and Certification Bodies (ONC-ATCBs). CCHIT has already certified 40 products in the latter category.

“ONC-ATCB certification is not a guarantee of meaningful use, but there are times when it may suffice, like with niche products in podiatry,” she said. “But we’re finding that many vendors want the advantages of being dual-certified.”

In November, CCHIT will introduce its EHR Alternative Certification for Hospitals (EACH) program, designed for facilities using self-developed or customized EHR systems. The new program will use the same HHS criteria and NIST test procedures used in the ONC-ATCB certification process.

Bell stressed that although certification is a catalyst for EHR, it can’t change hearts and minds. “We still need to change the culture of how IT is perceived in the medical world,” she said. “And that means engaging all the stakeholders, including physicians and patients. Many physician practices still view EHR as an expense that offers poor return on investment (ROI). But it’s really not about ROI. It’s about running your business more efficiently and competitively.”

Bell noted that banks in some regions are now offering low-interest loans for EHR implementation through the Regional Extension Center program. “Because we’re no longer married to servers, EHR costs are coming down significantly,” she said. “A physician practice can take advantage of Web-based systems or cloud applications. In some cases, most of the cost can be reimbursed by meaningful use.”

But Bell knows that a change in culture is much harder to achieve than a technological solution. “In this field, culture eats technology for lunch.”

Source    :     http://www.healthcareitnews.com/news/cchit-chair-certification-moving-right-direction

Filed under: EHR, EHR companies, Electronic Health Records on October 20th, 2010 | No Comments »

ORLANDO – Surgeon General Regina M. Benjamin learned a few things in her old job running the Bayou La Batre Rural Health Clinic in Alabama. First, the job didn’t just entail “sewing up the shark bites” – there were plenty of “land sharks” (regulators and red-tape dispensers) to fend off, too. Second, EHR are an absolute must-have.

Speaking at the 82nd annual convention and exhibit of the American Health Information Management Association (AHIMA) on Tuesday, Benjamin recounted her years  at the clinic she founded in 1987, in a tiny Gulf Coast shrimping village – a place where clinicians, mindful of the ever-present threat posed by the region’s severe weather, took notes on patient records with waterproof ink.

In 1998, the clinic was devastated by Hurricane George. In 2005, it was ravaged by Hurricane Katrina, flooded and nearly destroyed.

Benjamin showed slides of row after row of patient medical records, laid end to end drying out in the sun. “HIPAA didn’t like that,” she said to laughter.

Then, in 2006, just as it was set to reopen, the Bayou Clinic was destroyed by fire. To audible gasps, Benjamin showed another photo of health records reduced to blackened ash.

Upon rebuilding, Benjamin was determined. “I knew we had to find a better way,” she said. “This time, we had to have an electronic health records.”

Luckily, having absorbed the lessons learned by those disasters, “buy-in was never an issue,” said Benjamin. “The staff was adamant.”

Because, of course, implementation made sense on so many levels – enabling prescription information to be sent with the click of a button, and the ability to engage patients in their own care.

Benjamin illustrated these benefits with two touching stories of her interactions with her old patients. “I miss my patients,” she confessed. “But now I have 300 million patients.”

Upon adoption, EHRs at the tiny clinic made life “easier for the clinicians and better for the patients,” Benjamin said – imploring that other care providers, large and small, avail themselves of those same benefits. “We have to put patients first,” she said. “It is so important that we get our records in electronic format.”

Source   :  http://www.healthcareitnews.com/news/surgeon-general-says-ehrs-must

Filed under: EHR, Electronic Health Records on October 12th, 2010 | No Comments »

By Mark Wallin

For many years we have been hearing an increasing amount of information regarding Electronic Health Records (EHR) and related technologies with acronyms such as EMR, PHR, HIE to name a few. More recently, we have been hearing an emphasis on incentives and programs that may be available to physicians that adopt or utilize technology and provide quality reporting, including the federally funded Electronic Prescribing (eRx) Incentive Program, PQRI (Physicians Quality Reporting Initiative) as well as some privately funded programs from some health plans. Today, there is significant attention on what is commonly referred to as “meaningful use.”

The September 29 program at the Philadelphia County Medical Society will provide information on the “final rules” that were announced last month by the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC), which will guide desired EHR use for the next few years, including “meaningful use” requirements, and identify how medical professionals must use EHRs to improve care, in order to be eligible for financial incentives for Medicare (up to $44,000 over five years) and Medicaid (up to $63,750 over six years) under the Health Information Technology for Economic and Clinical Health (HITECH) Act, which was part of The American Recovery and Reinvestment Act of 2009 (ARRA), also known as the Stimulus Bill passed in February 2009.

The program will also address elements of the HITECH Act which authorizes a Health Information Technology Extension Program, including the creation of Regional Extension Centers (RECs). ONC awarded two RECs in Pennsylvania, both won by Quality Insights of Pennsylvania (QIP) and its sub-contractors. The RECs in PA, named PA REACH, (“East” and “West”) specifically target primary care providers for support in achieving meaningful use of EHRs. Meaningful use incentives are available to a wide selection of specialties; however, PA REACH will provide services to eligible primary care physician practices, subsidized by the ONC grant.  The grant subsidies will mean very low fees from PA REACH for consultations regarding technology needs assessment and acquisition, and implementation support for technology adoption in order to help participating physician practices achieve “meaningful use.”

In addition, and just as important, it is critical for all practitioners to understand and take advantage of the value of technology beyond the incentives of the next few years. The long-term purpose of technology must enhance and improve care and safety for patients; improve efficiencies and access to clinical data for physician practices, while supporting workflows and driving cost savings.

Technology should be viewed as a tool (or tools) by which the best individual patient care can be delivered based on the most robust information made available at the point of care, and to be able to measure and evaluate populations of care within the practice. This is a critical perspective to maintain while considering technology adoption or enhancements. Technology must be adaptable enough to support the service-based claims reimbursement processes used today as well as the outcomes-based or value-based claims reimbursement processes that are likely to become the norm in the years ahead.

Source     :      http://www.physiciansnews.com/2010/09/08/getting-clear-on-ehr-incentives-and-value/

Filed under: EHR, EHR companies, Electronic Health Records on October 5th, 2010 | No Comments »

Washington — The Health IT Policy Committee on Aug. 14 approved recommendations to the federal government on establishing a new process for certifying electronic health records.

To be eligible for Medicare and Medicaid incentive payments under the federal stimulus bill, physicians and hospitals must be able to demonstrate “meaningful use” of certified EHR technology. Federal certification means that a system is able to achieve the minimum government requirements for security, privacy and interoperability, and that the system is able to qualify the user for bonuses under meaningful use standards.

Currently, the Certification Commission for Health Information Technology is the only certifying body recognized by the federal government. But a policy committee work group noted that “considerable confusion” exists about the certification process used by CCHIT, so the panel recommends expanding the number of approved certifying bodies. CCHIT also has been criticized because it both sets criteria and certifies vendor systems, the work group noted.

Eliminating the CCHIT monopoly on certification was part of five main recommendations that the policy committee made to the federal government. They are:

• Focus certification on meaningful use.
• Leverage the certification process to improve progress on security, privacy and interoperability.
• Improve objectivity and transparency of the certification process.
• Expand certification to include a range of software sources.
• Develop a short-term certification transition plan.

Regarding the final recommendation, the committee favors creating an expedited process so federally certified products can get to the marketplace as soon as possible. Recognizing that the meaningful use criteria and other items relating to certification must go through a regulatory process that is not likely to end until the beginning months of 2010 at the earliest, the short-term transition plan calls for establishing “preliminary HHS certification” so vendors who are developing products pending the release of the final regulations can be ready to move as quickly as possible after the regulatory process is complete.

The committee recommends that certifications obtained during the transition period be valid at least through 2011, the first year EHR bonuses become available.

CCHIT said in a statement that it has been working closely with the Health IT Policy Committee and that it concurs with the recommendations.

Source    :    http://www.ama-assn.org/amednews/2009/08/31/gvsf0904.htm

Filed under: EHR, Electronic Health Records on September 28th, 2010 | No Comments »

A study by Frost & Sullivan predicts that revenue for the U.S. ambulatory electronic health record (EHR) market will double from $1.3 billion in 2009 to an estimated $2.6 billion in 2012. Further, by 2013, the market will reach its peak, posting revenue of $3 billion. However, by 2016 market saturation will have occurred and revenue is expected to fall to $1.4 billion.

Published this month, the U.S. Ambulatory EHR Market report said that, while the federal funds from the American Recovery and Reinvestment Act of 2009 and the Medicare and Medicaid EHR incentive programs are contributing to the acceleration of EHR adoption, there are other factors such as the need to improve safety and the drive to build greater efficiency into physician workflows that are important drivers in the adoption of EHRs.

“I think the number one driver [of ambulatory EHR adoption] is the change in reimbursement, the fact that it is becoming so complicated to document the process of care to get paid by the government as well as commercial payers,” said Nancy Fabozzi, a senior industry analyst at Frost & Sullivan and the report’s author. “Everybody thinks that fee-for-service is doomed and we have to have a new system of reimbursing physicians for the quality of care instead of the quantity of care because costs are exploding.”

In an interview with InformationWeek, Fabozzi said another reason for the adoption of ambulatory EHRs is that many providers have practice management systems that are old and need to be updated as they move to ICD-10 and HIPAA 5010 requirements.

Personalized healthcare becomes a reality with optimized IT infrastructures

Healthcare – The System of Systems

She also said that there has been an ongoing upward trajectory in the adoption of EHRs for the past decade, albeit slow prior to the injection of federal funds to jumpstart EHR adoption.

“It’s been slow but it has been a continual upward trajectory. That train was moving anyway, but it’s now moving a little bit faster because of the policies of the Obama administration. If you’re pumping $40 billion into a marketplace it’s going to have some impact,” Fabozzi added.

Over the past year, the Health Information Technology for Economic and Clinical Health (HITECH) Act has significantly increased public awareness around the issue of EHRs. In addition to direct payments to physicians and hospitals for the meaningful use of EHRs, HITECH will indirectly stimulate the market by enticing additional stakeholders like commercial payers, professional medical societies, healthcare manufacturers, and various nonprofit organizations to help physicians and other providers successfully adopt IT in their practices.

Source      :       http://www.informationweek.com/news/healthcare/EMR/showArticle.jhtml?articleID=227200057&queryText=ehr

Filed under: EHR, Electronic Health Records on September 20th, 2010 | No Comments »

Funding incentives for EHR use is the main goal of the Centers for Medicare & Medicaid Services’ (CMS) meaningful use initiative, and there are incentive programs for both hospitals and eligible professionals, according to Elizabeth Holland, health insurance specialist at the Department of Health and Human Services, who spoke during a CMS-sponsored webinar Aug. 8.

In speaking to the program specifics for eligible practitioners, Holland explained that the American Recovery and Reinvestment Act (ARRA) states that 90 percent or more of their covered professional services in either an inpatient or emergency room hospital setting are not qualified for incentives. In addition, there are differences in the Medicare and Medicaid programs, as the Medicare incentive program is federally run by CMS and the Medicaid incentive program is voluntary and is state-run.

According to CMS, Medicare eligible professionals were defined as one of the following:

• Doctors of medicine or osteopathy;
• Doctors of dental surgery or dental medicine;
• Doctors of podiatric medicine;
• Doctors of optometry; and
• Chiropractors.

Likewise, Medicaid eligible professionals included:

• Physicians;
• Nurse practitioners;
• Certified nurse-midwives;
• Dentists; and
• Physician assistants working in a federally qualified health center (FQHC) or rural health clinic (RHC) that is also led by a physician assistant.

Meaningful Use requirements

After distinguishing who can take part in the incentive programs, meaningful use has to be reached for EHR use as mandated in ARRA law in order to receive incentives.

“Basically, meaningful use is not just having certified EHR technology, we need use it in a way that makes a difference,” said Travis Broome, health insurance specialist at CMS. In the meaningful use rule, he noted that the CMS pinpointed five areas in which to focus, including the improvement of quality, safety, efficiency and the reduction of health disparities; the engagement of patients and families in their healthcare and the improvement of care coordination, population and public health–all while maintaining privacy and security.

Meaningful use, established in three phases: 2011, 2013 and 2015, respectively, specifies three components, according to Broome. These components are:

• Use of certified EHR in a meaningful manner (e.g., e-prescribing);
• Use of certified EHR technology for electronic exchange of health information to improve quality of healthcare; and
• Use of certified EHR technology to submit clinical quality measures (CQM) and other such measures selected by the Secretary.

Specifically for the first phase of objectives and measures reporting, which should be met by 2011, eligible practitioners must complete 15 core meaningful use objectives, five objectives out of 10 from a menu set and six clinical quality measures (three core or alternate core and three out of 38 from a menu set). However, practitioners should be “focusing more on use, not reporting on that use,” stressed Broome.

How to Participate

In order to take part in the EHR incentive program, providers must register via the incentive program website, be enrolled in Medicare FFS, MA, or Medicaid (FFS or managed care) and have a National Provider Identifier (NPI), offered Michele Mills health policy analyst of the Family and Children’s Health Program Group, Center for Medicaid and State Operations, CMS.

In addition to these requirements, the practitioners must use certified EHR technology and Medicaid providers may adopt, implement or upgrade technology during their first year, she said.

Mills also noted several differences between the Medicare and Medicaid Incentive Programs, citing that in the Medicare program, the federal government will implement the EHR incentive program starting in January 2011. The meaningful use definition is common across Medicare and payment reductions begin in 2015 for providers that do not demonstrate meaningful use.

For Medicaid however, the EHR incentive program is voluntary for States to implement and most are expected to start by late summer 2011. States also can adopt certain additional requirements for meaningful use and there are no Medicaid payment reductions for providers who do not demonstrate meaningful use.

As early as this fall, certified EHR technology will be available and listed on the CMS website and in January 2011, registration for the EHR Incentive Programs begins, said Mills, noting that Medicare EHR incentive payments are slated to begin in May 2011.

“Right now, we are doing a lot of outreach to get the word out on what the rules are all about and how you can become a meaningful user,” said Mills. And for Medicaid providers, states may launch their programs if they so choose and many are interested in implementing their program in January [2011], she noted. “They want to get this money into your hands as soon as possible,” she concluded.

Source   :   http://www.healthimaging.com/index.php?option=com_articles&view=article&id=23617:cms-webinar-eligible-professionals-can-expect-ehr-incentives-in-2011&division=hiit

Filed under: EHR, EHR companies, Electronic Health Records on September 14th, 2010 | No Comments »

MOUNTAIN VIEW, CA – The U.S. ambulatory EHR market, which was at $1.3 billion in 2009, is forecast to reach $2.6 billion in 2012, according to new analysis from research firm Frost & Sullivan.

The rate of electronic health record adoption among U.S. physicians expects to increase over the next two to five years due to a combination of changes caused by healthcare reform and financial subsidies from the HITECH program, the report notes.

“Today, many public and private stakeholders are committed to harnessing the power of information technology to improve the quality and efficiency of our healthcare system,” states Frost & Sullivan Senior Industry Analyst Nancy Fabozzi. “We are finally seeing providers make the transition from siloed paper charts to interoperable electronic health records.”

Growing complexities in managing the reimbursement process with both government and commercial payers that reward quality over quantity in the care provided will increase the use of EHRs and related solutions for physicians and other clinicians, Fabozzi says.

She predicts HITECH will indirectly stimulate the market by enticing additional stakeholders like commercial payers, professional medical societies, healthcare manufacturers, and various nonprofit organizations to help physicians and other providers successfully adopt information technology in their practices.

Revenues are expected to fluctuate considerably over the next five to seven years, resulting in significant year-over-year shifts.  This fluctuation happens as the market matures and increased competition comes into play, causing a decrease in pricing, she says.

Strategic partnering with a variety of stakeholders is important for survival in this market as consolidation on both the vendor and provider side increases. Innovative, provider-focused, and patient-centric technology companies that understand how to manage this industry’s unique combination of risks and rewards will achieve business progression.

“Branding and outreach must extend beyond physicians to include non-physician healthcare providers, as well as healthcare consumers,” notes Fabozzi. “Both should be directly engaged as advocates for the use of health information technology. Patients need to understand the role EHRs play in driving quality improvements and care coordination among all of their (physician and non-physician) providers.”

Source  :   http://www.healthcareitnews.com/news/ehr-market-projected-double-2012

Filed under: EHR, EHR companies, Electronic Health Records on September 9th, 2010 | No Comments »