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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.

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.

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
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• 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.”

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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.

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?

An EHR is like a good pair of shoes – you want them to fit right or you are going to feel the pain. And let’s face it, selecting the right electronic health record (EHR) for your practice is not an easy task – particularly for practitioners who may not have IT expertise. Plus, there are more than 400 providers of EHR/EMR products on the market today. It’s important to exercise caution and perform a thorough due diligence, but where should you start?

Nuesoft Technologies believes we have an amazing product that will truly improve your practice’s efficiencies and profitability, but we only want you to buy our software if it’s the “right fit” for you. We’ve got the insight of nearly 20 years of experience in the field of health information technology. But don’t just take our word for it. We encourage you to follow the suggested outline provided by Dr. Robert Lamberts in the Nov. 2009 issue of Physician’s Practice magazine. Lamberts successfully implemented an EHR in his office. Although he recognizes the fears and concerns of his peers, he also describes the positive impact the software has had on his practice.

Lamberts’ recommends that those considering purchasing an EHR start by first identifying any broken processes in their practice. What causes the most frustration to staff? To patients? Where is the most time wasted? Where is the greatest exposure to malpractice risks? Where is your office losing money? Improperly coded claims? Under-billing? Low volume? Over-staffing? Look at the whole practice – front and back office, not just at the providers.

Next, Lamberts recommends that you visualize what your “fixed” processes would look like. This is where you will develop your shopping list for that perfect pair of shoes! So what were your “fixes”? Never needing to search for lost charts – with an EHR, your charts are always a click away. Answering telephone inquiries – with charts immediately available, response times are much quicker. Improperly coded claims causing a delay in payment – with claim scrubbing capabilities you can get paid more quickly.

Now you are ready to start approaching vendors and looking for the practice management and EHR solution that best fits the needs of your practice. If the vendor does not suit you, cross them off your list and continue to the next vendor. And don’t forget to demo the software. Have a vendor representative walk you through how the software works, and ask lots of questions! Once you have a shortlist of vendors, consider the following and make your decision.

1. What is involved in product implementation?
2. Is the implementation process disruptive to your day-to-day operations?
3. What kind of training is available?
4. What is the response time if you have problems next week or next year?
5. How long has the company been around?
6. What are the hardware requirements – will it require you to buy new systems?
7. Who is responsible for data back-ups?
8. How will the data be securely stored to protect your patients’ privacy?
9. How often will the software/hardware need to be upgraded and what will this cost?
10. Is the solution scalable as your practice grows?

By now, you have a couple of vendors who are standing out from the rest. You like their graphic user interface, the functionality meets the needs of your practice and you are starting to get excited about how the new practice management and EHR solution can help your practice. Now it’s time to get references and ask your peers what they think about the software. Here are some questions you can ask:

1. How smooth was the implementation?
2. How well was training conducted?
3. What do you like best about the software?
4. What do you like least about the software?

Hopefully this has helped to further narrow your selection. The last bit of advice that Lamberts provides is to look at the purchase as a chance to improve your practice rather than an unwelcome expense. Remember that you get what you pay for and you shouldn’t waste your time on products that don’t meet the needs you identified at the beginning of the process. Focusing on cost first could rule out some of the best products and minimize your chance to find the best solution that maximizes your potential gains – giving you a shoe that just doesn’t fit.

Reference Link:
http://www.physicianspractice.com/index/fuseaction/articles.details/articleID/1425.htm

Source: November 2009 issue of Physicians Practice.

The “red flags” rule is now scheduled to take effect on June 1, 2010, after another delay announced earlier this week by the Federal Trade Commission as it considers new legislation that would exempt small businesses, including medical practices, from compliance. The rule mandates the creation of identity theft prevention programs, and will apply to any organization that can be considered a creditor with “covered” accounts (i.e.-commercial accounts that involve multiple transactions). Most providers, many medical billing companies and some health plans are expected to comply.

The American Medical Association, American Academy of Family Physicians and other industry groups have weighed in against the rule, on the basis that physicians do not meet the definition of creditors. A completely sensible argument. But medical practices need to proactively engage in some agreed-upon set of identity theft prevention practices. It’s in the best interest of consumers, not to mention practice owners, who’ll otherwise pay the price through legal costs, or through the provision of services for which they would never collect payment. Incidences of medical identity theft are increasing – enough to raise the gander of the government, which commissioned a study to assess and evaluate the scope of the problem. And smaller medical practices (which account for nearly 80 percent  of all U.S. practices) may be more vulnerable, as thieves could perceive them to be lower risk targets based on the assumption that they lack the sophisticated security procedures of hospitals or larger health care organizations.

Despite the widespread outcry from industry groups, the actual impact on a practice for complying with the red flags rule may be minimal. The new rule would simply buttress state privacy laws that already require health care organizations to respond to breaches of certain patient information. In addition, there is a great deal of overlap between the proposed FTC regulations and HIPAA, which applies to medical practices or other entities that are conducting electronic transactions.

Medical practices concerned about compliance can learn more at: http://www.ftc.gov/bcp/edu/pubs/articles/art11.shtm or http://www.ama-assn.org/ama1/pub/upload/mm/368/red-flags-rule-edu.pdf.

As the health care community watches the EHR meaningful use criteria take shape under the American Reinvestment and Recovery Act (ARRA), some may be wondering whether the push for more interoperable health IT systems will truly improve care and reduce costs. Skeptics might find an example of success from an unlikely source: the government.

The Federal Health Architecture, which coordinates federal efforts for national healthcare IT initiatives under the Office of the National Coordinator (ONC) for Health Information Technology, kicked off in March 2008 with a goal to achieve interoperability in government health IT operations. On board are 20 federal health agencies and 16 private sector entities that are all able to securely exchange electronic health data through the National Health Information Network ‘s CONNECT software, which is available to all states through an open source platform. Results from pilot users are starting to come in, and they look promising.

The Social Security Agency was one of the first to begin using the CONNECT network, through a partnership with Virginia’s Regional Health Information Organization, MedVirginia. Initial data has shown decreased time to determine benefits eligibility (weeks to days), faster decisions on outstanding claims, and significantly reduced administrative work and costs.

The SSA/MedVirginia partnership, and FHA in general, offer a microcosm of what health care IT might be like if HHS succeeds in its vision under the ARRA to consolidate all information exchanges relevant to electronic patient records. Currently, the Health IT Policy Committee is requiring that by 2011 EHRs include seven electronic data exchanges; including e-prescribing, lab results, clinical data summaries from provider to provider, biosurveillance, immunization registries, public health and quality measurement.

While these attempts to facilitate shared, structured data exchange may still fall short when it comes to standardizing workflow within a practice (see Nuesoft blog post highlighting the impact of technology standards on practices), the government through its efforts is giving health care a needed push down the path toward interoperability, and thus improving continuity of care and communication among providers

Gartner has released its 2009 Hype Cycle Report about technology trends. Cloud computing made the list. There is definitely a developing hype surrounding cloud technologies. As more and more companies jump on the cloud bandwagon, the true nature – and benefits – of these technologies become increasingly amorphous. However, concerns about the security of cloud computing as it relates to health care may have been over hyped, as well. In fact, one can easily make the argument that it is easier to monitor and maintain security in a hosted cloud model than it is for a client-server, considering that a typical application using a legacy client server is wired separately to the Internet. This makes for a distributed nightmare of a mess — with questionable protections that are potentially vulnerable. Historically, the majority of security breaches have occurred with this computing model (if not from a stolen laptop!) All you have to do is look at your own PC every time you connect to the Internet and witness the barrage of messages about virus protection to get a sense for this. Who is securing your connection and protecting your data? Some pre-packaged and potentially out of date virus protection software with some dubious firewall, or a group of top-notch engineers equipped with monitoring and protection tools more powerful than the hackers?

There has been much discussed and written recently about how cost control is a necessary component of health care reform. CNN recently highlighted the six primary sources of wasteful health care spending, which amount to a whopping $500 billion. Claims processing made the list — and for good reason.

As a medical billing software company that also functions as an approved clearinghouse of medical claims, Nuesoft witnesses first hand the administrative costs and inefficiencies related to claims adjudication. There are an estimated 6 billion medical claims filed each year by medical practices and hospitals. If every single one of those claims could be filed according to the exact same data protocols, with no payer specific differences for required fields; imagine the time and money that could be saved. By simply adding uniformity, transparency and clarity to the exchange of data between providers and payers, and leveling the playing field for all involved, we can vastly impact the system, and help medical providers divert resources away from administration and back toward activities that support patient care.

A recent technology survey published in the September issue of Physicians Practice had physicians rank their priorities when implementing new technology. Fifty-five percent replied that it was the cost of the technology rather than the benefits that mattered to them the most. .

Fortunately, physicians can have their cake and eat it. Choosing an Internet-based practice management system can give your practice the benefits of the latest technology in a way that is both cost-effective and quick to implement. Because there is no extra hardware to buy or install locally, set-up is simpler and your staff can focus their efforts on training. 

The same survey also found that 69 percent of those who bought an EMR system reported increased workflow efficiency. Although no figures were given for implementing a practice management system, NueMD clients report seeing an average of four more patients per week and working 23 min fewer minutes each day. 

While investing in technology for your practice may require parting with money that you’d rather not spend, the evidence suggests that, if properly implemented, software solutions will actually save you money and increase your profits.