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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

Hospitals and practices are concerned about the security of their patients’ information, and rightfully so. The fear of data pirates and hackers prevents many health providers from making the switch from paper records to electronic ones. However, as this Colorado hospital discovered, sticking to paper records won’t prevent the possibility of confidential patient information being compromised or stolen.

In fact, providers wanting to maximize the security of their patient information might consider that it is much easier to keep patient information secure if it is housed in digital format with proper access and audit controls. Client-server-based systems that still rely on staff backing up information on tapes are simply relocating the problem, as a rash of news stories recently has proven, but remotely hosted Internet-based systems can exceed HIPAA regulations, take care of backups in a secure data center, and protect data being transmitted between you and the server by using a secure, private platform that avoids the cluttered, public forum of the World Wide Web.

You can find out more about the differences between client-server technology and Internet-based technology here.

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?

The Health IT Policy Committee on Friday released its recommendations for electronic health record (EHR) certification under the ARRA. In general, the recommendations will place less emphasis on features and functionality, and focus more on the criteria for meaningful use, including interoperability, privacy and security. The recommendations call for multiple certification organizations (rather than just one), with accreditation by the National Institute of Standards and Technology (NIST). Nuesoft applauds the committee’s effort to move toward a more “transparent and objective process”, where the emerging model appears to level the playing field for vendors with newer, more innovative technologies and system and data architectures.

While the government’s incentives for adopting an EHR have been cautiously welcomed by many in the health care industry, providers and software vendors alike are struggling to come to grips with one key term: “meaningful use”. A practice must show meaningful use of an EHR before it is eligible to receive the incentives, and finding a definition that applies to all sizes or practices and hospitals seems to be no mean feat . The Medical Group Management Association (MGMA) is one organization hoping to modify the HIT Committee’s definition before it is finalized by the Office of the National Coordinator (ONC). MGMA sent a letter to the ONC at the end of June that recommended that, among other things, a broader set of administrative requirements be included as an integral part of the definition of meaningful use: essentially, that there is a focus on billing and practice management efficiencies as well as EHR efficiencies. In particular, it suggested eligibility verification, real-time claims adjudication and electronic payment remittance, all things that users of robust practice management software are already enjoying.

Additionally, MGMA is concerned that the definition of “meaningful use” as it currently stands has been developed with larger provider groups and hospitals in mind, and will prove too burdensome for smaller practices. In another letter sent last month to the ONC, MGMA listed ten recommendations to combat this.

A recent article in the Washington Post suggests that practices may be more willing to automate their offices if they can find a truly integrated practice management and EHR system. So far, the EHR adoption rate has been only 21 percent, but Nuesoft Technologies CEO Massoud Alibakhsh believes the answer lies in interfaces between what are known as “rich Internet applications”, which allow smaller offices to go paperless without having to invest in hardware for both EHR and practice management systems, or rely on potentially less secure remote applications that use Citrix-based “terminal server” technology.

Read more about the evolution of technology and what makes rich Internet applications different from terminal server-based applications in this fact sheet.

We are pleased to announce the winners of the Nuesoft Xpress 15-year scholarship program. Five college and university health centers each received an in-kind donation of up to $15,000 toward Nuesoft Xpress™ health center management software.  

The grant recipients are: College of San Mateo, Dominican University, Samford University, St. John Fisher College and University of Missouri – St. Louis.  

You can read more about the scholarship initiative and the winning schools here. Congratulations to all five schools! 

There has been a growing trend among college health centers toward offering student health insurance plans. With budgets being cut and costs continually rising, health centers are trying to find new ways to bring in revenue.

According to the results by the United States Government Accountability Office, about 20 percent of college students aged 18 through 23 were uninsured in 2006. It may seem, then, as through mandatory student insurance plans would be a boon for both students and administration alike, however, an article in The Capital Times reveals that many students are unwittingly left underinsured by taking the university endorsed policy. Some college-offered insurance programs offer low ceilings at $30,000 and “interior caps” on surgery and hospital stays. Many students are able to find better programs off campus.

Often, this is because colleges are torn between trying to find the right balance of affordability and quality. When shopping for a student insurance plan, Dana Mills, MPH, chair of the American College Health Association’s (ACHA’s) Student Health Insurance Task Force and director of the student health center at Wisconsin’s Marquette University makes the following suggestions:

More information on student insurance plan can be found here.