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The newest podcast in Nuesoft’s monthly medical practice management podcast series is now available. Titled ROI-based Practice Analysis, the podcast covers the ways a practice can improve ROI and cash flow through a cost-benefit analysis. If you are a doctor or office manager and have ever wondered what insurance company is most profitable or how much cash your practice generates on a monthly basis, this podcast will help you answer these questions.

Also, if you would like to hear more podcasts on health information technology topics, check out http://itpodcast.org/blog/, a health care IT podcast series and blog.

HHS announced yesterday that “the Certification Commission for Health Information Technology (CCHIT), Chicago, Ill. and the Drummond Group Inc. (DGI), Austin, Texas, were named by the Office of the National Coordinator for Health Information Technology (ONC) as the first technology review bodies that have been authorized to test and certify electronic health record (EHR) systems for compliance with the standards and certification criteria that were issued by the U.S. Department of Health and Human Services earlier this year. In other words, being certified by CCHIT or DGI is the first step for a vendor to ensure that their customers will meet meaningful use criteria. Nuesoft (click here for a list of vendors) is already CCHIT-certified and guarantees that its software will meet the meaningful use criteria.

If anyone is still a little confused about meaningful use and the HITECH act, here is a helpful podcast on the top five things to know about meaningful use and an upcoming webinar on meaningful use.

Correct coding – and knowledge of medical necessities rules in particular – is an after thought for many medical office staff, but it could mean the difference in thousands of dollars of revenue each year. For instance, by identifying and correcting just $100 in coding errors, a practice can increase payer reimbursements by as much as $26,000 annually.

Filing clean claims is additionally an important way to steer clear of an audit by the Office of the Inspector General (OIG) or the Centers for Medicare and Medicaid Services (CMS). If this has not been a concern for medical practices in the past, it stands to be soon. The Patient Protection and Affordable Care Act that became law earlier this year includes a mandatory compliance program for providers enrolled in Medicare or Medicaid programs.

“Taking the time to be knowledgeable about medical necessities and file claims cleanly the first time really pays off in the end,” said Mark Weber, a content development manager with the Medical Necessity and Compliance Division, at 3M Health Information Systems. Weber is the featured speaker in Nuesoft’s August podcast, “The Down and Dirty on Clean Claims.”

“If you have processes in place to help you code more carefully, you will spend less time looking up codes and doing reworks, resubmitting claims, and dealing with write-offs – not to mention a smaller A/R,” Weber said. “Time is money, and with estimates of up to $70 to rework a claim, it’s hard to justify not being more knowledgeable and thorough about coding.”

To hear more advice from Mark Weber, tune into the podcast.

Last week we announced the winners of our Make Software Sexy Contest. The contest was a chance for our clients to express their creativity in a video or photo while wearing a free Nuesoft T-shirt for the chance to win several different prizes. Our clients went above and beyond in their entries and we were glad the voting was left up to the public so we didn’t have to choose a winner.

“We wanted to do something out-of-the box to thank our customers and celebrate our brand,” said CEO and Founder Massoud Alibakhsh. “We came up with the idea of a T-shirt giveaway, and then developed a short corporate video to encourage customers to order their free shirts. The video was so much fun for our staff – and so well received by clients – that we created the contest as an expansion of the shirt giveaway.”

More than 100 medical practices or student health centers ordered shirts, prompting 20 entries into the contest. Unexpected excitement came as the video contest was winding down. It was neck-and-neck for McKenzie Medical Imaging and Cascade Medical Center. In the end, when the votes were counted at 5 p.m. on Friday, McKenzie pulled out the win. The photo contest was a landslide win with Jocelyn from vascular surgeon Jean W. Gillon, M.D.’s office receiving 6,000 votes. Both first-place winners will receive a 40-inch LCD TV for their medical offices.

Second place winners (and recipients of a $250 Visa gift card):

• Video – Cascade Medical Center in Cascade, Idaho
• Photo – Ophthalmologist Sheila Wright-Scott, M.D., in Lancaster, Calif.

Third place winners (and winners of a catered lunch for their office):

• Video – Tarleton State University Student Health Center in Stephenville, Texas
• Photo –  Sutherland Neurology in Marion, Ohio

We greatly appreciate all the effort, humor and creativity our clients put into the videos and photos. Thank you!

Many medical practices have implemented sophisticated marketing programs and/or hired consultants to build their brand and create awareness, but they may not be leveraging public relations tactics. Nuesoft’s new medical practice management podcast, “Putting the PR into your Practice:  Strategies to Build Your Reputation and Credibility with Patients,” discusses why public relations is so critical to a practice’s overall marketing strategy.

What others say about you is so much more credible and important than what you are able to say about yourself,” said Laurie Mobley, a health care communications specialist and vice president with Brand Resources Group. “That is what public relations is all about — harnessing influencer opinions to build the perception of your practice.”

The podcast, which is available today via the Nuesoft website, gives tips to help practices get started with a public relations campaign, talks about the PR tactics that will most benefit medical practices, and reviews emerging health care trends that will have an overall impact on a practice’s marketing approach.

As we move into the era of software in the cloud, find out why legacy health information technology solutions will no longer be a viable option for medical practices. Click here to listen to the new June podcast featuring Founder, President and CEO of Nuesoft, Massoud Alibakhsh. If you are still confused about what it means to access software in the cloud, click here to watch Nuesoft’s engaging animated video to find out more.

The Patient Protection and Affordable Care Act (PPACA) was signed into law on March 23. The bill, which has a price tag of just under $940 billion over 10 years, will overhaul the nation’s health care system and guarantee access to 32 million Americans who currently lack health care insurance.

Some of the key provisions of the legislation:

• Requires most people to have health insurance coverage by 2014
• Gives a tax credit for small businesses to help make employee insurance coverage more affordable
• Expands Medicaid to 133 percent of the federal poverty level
• Imposes new regulations on all health plans that prevent insurers from denying coverage for any reason (including preexisting conditions) or rescinding coverage for people who get sick
• Provides a $250 rebate to Medicare beneficiaries who are impacted by the Part D coverage gap
• Gives small businesses, the self-employed and uninsured access to coverage through new state-based exchange programs
• purchased
• Allows young people up to age 26 to remain on their parents’ insurance policy

We asked a sample of Nuesoft clients about whether the new healthcare legislation will impact their practice/business.

Dr. Michael Seyfried

Michael Seyfried, M.D.
Family Practice Associates – Atlanta
NueMD user

“In short, anything Government does in relation to payment of healthcare services will impact our practices. The larger issue is in what way and to what magnitude. As members of the most highly regulated and price controlled industry in America we have seen an incredible systematic usurpation of our capacity to determine freely what services we provide, to whom, at what fee for years. This has been led primarily by the federal government by its Medicare reimbursement rules. When payment formulas, coding and documentation rules and fixed fee schedules (DRGs) etc. are imposed by Medicare, and physicians continue to provide the same care despite the cut in reimbursement, the private payers are right behind with similar cuts or restrictions because we (physicians) have proven, we may complain, but we won’t quit.

He who pays makes the rules!!!”

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Marcy Beahm

Marcy Beahm, CMA
Office Manager
Ernest Beasley, M.D. – Atlanta
NueMD user

“Yes. It will decrease revenue by lowering reimbursement and increasing taxes. It will decrease the income of physicians and staff because of decreased revenue and the need for cost cutting. It will work to the detriment of the patient by limiting Medicare services. It will cause physicians, in some instances, to totally withdraw from Medicare/Medicaid programs.”

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Brandy McDonald
NP Operations Director
Transform HealthRx
Statesboro, Georgia
NueMD EHR user

“No. TransformHealthRx feels it is well situated to deal with a broad array of potential outcomes. We have developed our offering around the delivery of primary care services, so even with the addition of potentially hundreds of new patients with new access to medical care, we feel confident that we can accommodate them.”

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Brenda Dalton, MBA, MSN, RN-C, WHNP
Director, Department of Student Health Services
Spelman College – Atlanta
Nuesoft Xpress user

“At this stage, I don’t know how the new health care reform will impact college health. I perceive only positive benefits and not much change in the way we currently do business. I have always thought college health is the most cost effective health care around and the ways we provide these services are typically quite thrifty. What I hope will happen is that we won’t have student health insurance companies denying claims because they term a “urinary tract infection” a “pre-existing condition” to keep from paying the claim when there is no evidence that this is nothing more than an episodic condition.”

________________________________________________________________________________________

Barbara Dunn, President/Owner
MedRecovery Solutions, Inc. – Houston
NueMD user

“I see this as a positive impact for the physicians we bill for.

Too many uninsured patients are seen in the ER / hospital with no payment source – even Medicaid rates are better than no payment at all!”

Have something to add to the dialogue? Post a comment.

I’ve been following with interest the blog dialogue about data backups. Having spent more than a quarter century in the information technology industry and the health care technology business, I’d like to offer our perspective on this very critical issue.

John, you’re right.  A very large number of doctors in the market for EMRs today are still considering client server systems, and they should be very concerned about finding a viable backup method. However, the data backups that you’re talking about —  which may be nice for some files such as Excel files or family photos — do not come close to offering the level of protection necessary for mission critical health care applications like electronic health records.

Backing up a live database containing patients and clinical information in a secure (consider HIPAA) manner and with a high degree of confidence on a regular basis is considerably more complex. We’re talking about a complete paradigm shift in the way that doctors think about data backups, which, if not yet recognized, will soon envelop the health care industry as more and more doctors begin to use EMRs. Do you seriously think banks use some of the services you mentioned to back up financial data?

Software as a Service (SaaS) vendors, like Nuesoft, are not just in the business of providing process automation to the healthcare industry in the form of Electronic Medical Records. HIPAA compliant redundancy in the form of live a backup is at the core of this technology offering. We provide central delivery of fault tolerance, load balancing, and other critical aspects of managing a network. It’s much more than trivial passive backups. We guarantee up-time and continuous secure access to clients’ data in real time.

You alluded to the trust factor. If trust is at the core of this discussion, it’s hard to imagine that most doctors would trust a staff member, let alone themselves, to sufficiently manage their backup processes (not to mention provide for the security and on demand access of their data). You can look to numerous recent examples in the news media of security breaches or other unfortunate and unnecessary mishaps that occurred when well-intentioned medical practices took on the back up responsibility. If an annoying little article in the local paper is not enough to deter doctors from handling their own IT tasks, perhaps the HITECH amendments to HIPAA will. The steep new civil and criminal penalties – including fines of up to $1.5 million, and public reporting requirements would be enough to put a practice out of business. That’s why we definitely advise you or anyone else against backing up this sensitive data on a USB stick.

Thank you for engaging us in this discussion. We’ve enjoyed it so much that you got us thinking more about the need to extend the conversation to health care professionals, and so we are planning to write an article about the many complexities of IT management for small medical practices in the modern era. Of course, you can bet that we’ll let you know when it is available!

–Massoud Alibakhsh, President and CEO

The announcement earlier this month by the Office of the National Coordinator for Healthcare IT (ONC) about its notice of proposed rulemaking for EHR certification may have overshadowed some other significant news recently coming from the U.S. Department of Health and Human Services (HHS). With the anticipated increase of electronic health record adoption over the next few years, it appears that in addition to rolling out a new voluntary EHR certification program, HHS – via its daughter agency FDA – is considering regulation of health information technology systems.

Dr. Jeffery Shuren, director of FDA’s Center for Devices and Radiological Health (CDRH), gave testimony for a hearing late last month of the Health Information Technology (HIT) Policy Committee, Adoption/Certification Workgroup. The purpose of the hearing was to discuss potential HIT safety concerns and how to address them.

According to Shuren: “The FDA recognizes the tremendous importance of HIT and its potential to improve patient care. However, in light of the safety issues that have been reported to us, we believe that a framework of federal oversight of HIT needs to assure patient safety.”

Shuren and the FDA are considering regulation under the premise that EHRs are medical device data systems (MDDS), and thus fall under the FDA’s regulatory jurisdiction. He presented a continuum of regulatory options – ranging from pre-market review to post-market surveillance.

Some in the HIT blogging community have written about the public health and safety benefits of increased oversight. But the challenge at hand for the government is to find a way to foster the development of safer systems, while not hampering innovation at a time when government, patients and industry are all finally recognizing HIT’s tremendous potential to control costs and improve patient care.

What are your thoughts? Is a voluntary, structured certification program like the one that will be rolled out this year under the Health Information Technology for Economic and Clinical Health (HITECH) Act enough to ensure that EHR systems will be safe? Or, do we need to take things a step further through a mandatory regulatory program?

In a recent post by John Lynn on the EMR and HIPAA blog, he broached the subject of off-site backup services, and suggested some solutions for medical practices that need a way to back up their patient data.

Nuesoft has nothing but respect for Lynn and the EMR and HIPAA blog, but we can’t help but feel that this post missed the mark a bit. Rather than encouraging medical practices to look for quick and easy fixes to the pesky backup problem, why not remove backups from the health information technology dialogue? Data backups are a by-product of client server technologies of the 1990s. To truly reach the level of widespread health information technology adoption that the government is envisioning, then we need to look toward more modern and viable HIT solutions.

Most EMR solutions installed in medical practices are client server models. While users of some of these client server systems may opt for a backup solution like those described in Lynn’s blog, the vast majority will handle backups themselves. Let’s be realistic – how many doctors have the time or the expertise to adequately replicate data and ensure that it is completely secure (and HIPAA compliant) and fault tolerant? To do so requires a practice’s main server and its database to be replicated via a back up server within the same network, or connected via a wide area network, and then monitored constantly. The answer is, most doctors aren’t equipped or staffed to handle back ups, and the result is that the back ups just won’t get done – or at least not to a level that is adequate or truly secure.

Nuesoft wonders, in this push for broad EHR adoption, why aren’t more people concerned about the fault tolerance issue and discussing it openly? EHRs are truly mission critical applications. Timely access to information by a provider can have life or death consequences. Consider this: there are 161,200 medical practices in the United States. If we assume that a conservative 45 percent of these practices adopt a client server EMR under HITECH, and that a mere 1 percent of those EHR systems go down and leave users without access to patient data, think of the number of practices – and patients — that would be impacted! Providers would be without access to patient charts, and would lack the ability to review drug allergy or interaction information, medical history, or other critical components of the patient record.

This is a frightening – albeit realistic picture of the potential risk that client server models, with their many shortcomings, pose to the health care system. It’s time to stop talking about ways to help physicians compensate for client server technologies, and embrace emerging technology models such as Software as a Service (SaaS), or cloud computing, which are better suited to a mission critical environment. Even in the event that a SaaS program is temporarily unavailable, the data is safe, whereas with a client server scenario the loss is more often than not a permanent loss and the downtimes are much lengthier. The HITECH Act gives us the perfect opportunity to usher in new technologies like SaaS that will expand interoperability and relegate legacy technologies to a thing of the past.