This week, CMS will begin issuing the first Medicare incentive payments for meeting Stage 1 requirements for the meaningful use of electronic health records, Modern Healthcare reports (LaFave Grace, Modern Healthcare, 5/18).
Under the 2009 economic stimulus package, health care providers who demonstrate meaningful use of certified EHR systems can qualify for Medicaid and Medicare incentive payments.
On April 18, CMS launched the attestation period for the meaningful use program (iHealthBeat, 3/28). About 150 health care providers have successfully attested, according to CMS. However, the number of payments that will be issued has not been determined.
Payment Details
The maximum first-year incentive payment for eligible professionals is $18,000, but they will not receive payment until they reach a $24,000 threshold in certain Medicare charges (Goedert, Health Data Management, 5/18).
Payments to hospitals and critical-access facilities will be determined by a number of factors, but the base payment is $2 million (Modern Healthcare, 5/18).
Health care providers will receive payments either through a paper check or through an electronic funds transfer.
According to CMS, more than $83 million in Medicaid meaningful use incentive payments have been issued since January (Health Data Management, 5/18).
Source: iHealthBeat
Electronic Medical Record (EMR) software is expensive and problematic to implement across most medical practices. The Cabinet NG electronic filing system is structured to provide the patient chart component of an EMR in a format and methodology that minimizes stress and disruption that frequently accompanies the rollout of a new software system.
Progress notes, patient information, images, prescriptions, insurance information, EOB’s and other medical records are all kept in an electronic chart. The user-friendly interface means staff and physicians will come up to speed quickly and with its secure networked design, any user in the office can enjoy the benefits of the system. Nurses, receptionists, support staff, and doctors can accomplish more with less effort.
Without medical practice workflow solutions, any growing practice is challenged to keep up with patient files and the backlog of paperwork.
Think about how much time is typically spent:
Our electronic filing solution supports the native document format of many existing applications, consolidating data into one organized and secure networked accessible system. In addition to basic filing, storage and retrieval, Cabinet NG provides extended integration with office applications such as:
If integration with existing systems is a concern, our professional services team can supply integration solutions that speed the deployment of document management within your organization. Our team can deliver utilities and custom programs to synchronize customer records, link documents with existing data, and process/workflow analysis to address the specific needs of your office environment.
Your medical practice will be more efficient and cost effective if you:
Are your filing areas brimming in patient charts, EOB’s, HIPAA forms and all the other documentation associated with your practice? Today, everything must be documented. Patient files are often unwieldy and cumbersome. Lost charts and patient privacy are an increasing concern as HIPAA compliance requires proper security and authorization of all paperwork.
As the practice grows, adding new support staff to manage patient charts is expensive and often put on hold. Finally, space is a premium – sometimes there aren’t enough examination rooms for patients. That is why more and more offices across the nation are going paperless and relying on medical practice workflow solutions.
With Cabinet NG, you can automatically create electronic patient folders from your Practice Management System. Importing/creating Standard Forms, EOB’s, Labs, Images, Notes, Emails, Letters, Prescriptions and Transcriptions is a snap and can be accessed from a single, secure (HIPAA) location. Speed the entry of patient information and reduce errors through standard filing templates that prompt the user for the required information and automatically complete information that is duplicated among forms.
Continue to use Microsoft Word, Excel, Outlook, etc. and follow your current business processes, but store all information in one place and in their original formats. You will be more organized and spend less time, gain instant and secure access to patient records, and easily integrate with current procedures–at check-in, nurses station, exam room, check-out, billing, and transcription.
Source: CNG
The federal government’s multi-billion-dollar investment in health information technology through the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 has the potential to make measurable improvements in the nation’s health care system, according to a report assessing the impact of the legislation thus far.
The first comprehensive review of HITECH, which was a key part of the American Recovery and Reinvestment Act of 2009, points to the need for a number of course corrections to ensure that the transformative potential of the Act is reached. The report was prepared by Manatt Health Solutions and supported by the California HealthCare Foundation, The Colorado Health Foundation, and the United Hospital Fund.
The report, informed by interviews with 24 leading health IT experts, provides a candid assessment of the progress made to date, the challenges that lie ahead, and what specific actions Congress and the Obama Administration should take to achieve HITECH’s ambitious goal of jump-starting the adoption of health IT in the health care industry.
Key findings of the report include:
Source: Manatt Health Solutions
Patients increasingly are communicating with their physicians online, but questions remain over reimbursements and security protections for Web-based consultations, the Los Angeles Times reports.
Meredith Ressi, vice president of research at Manhattan Research, said that about 42% of U.S. physicians report having discussed clinical symptoms online with patients. She added that more than 9 million patients report having e-mail communication with their physicians.
About 80 million more patients are interested in having electronic visits with their physicians, according to a 2009 Manhattan Research study of 8,600 U.S. adults.
Benefits
Health care experts say online visits benefit patients because they often are less expensive and more convenient than office visits.
Virtual visits also benefit physicians by allowing them to respond quickly to minor patient concerns while keeping office appointments available for patients who need in-person treatment.
Reimbursement Concerns
As of 2009, fewer than 5% of physicians who communicated online with their patients reported receiving compensation.
However, many large insurers have started paying physicians an average of about $30 per online visit, compared with $75 to $100 for office-based consultations. In addition, twelve states have instituted laws requiring health plans to pay for online visits and other telemedicine services.
Physicians typically do not receive payments for using e-mail to conduct “convenience services,” such as scheduling appointments or relaying test results.
Security Concerns
To receive reimbursement from insurers, physicians are required to conduct online visits via secure Web portals that include high levels of encryption to comply with HIPAA privacy and security rules.
However, most online communication between doctors and patients occurs casually, without secure Web portals, the Times reports.
Lisa Gallagher — senior director of privacy and security for the Healthcare Information and Management Systems Society — recommended that patients only communicate with their health care provider over secure websites that require a username and password (Zamosky, Los Angeles Times, 6/7).
Source: iHealthBeat
Electronic health record systems should expand to meet the needs of children and other vulnerable populations, experts said last week during a meeting of the Health IT Policy Committee’s meaningful use work group, Federal Computer Week reports.
EHRs for Children
Carolyn Clancy, director of the Agency for Healthcare Research and Quality, said studies show that about 21% of pediatricians use EHR systems, but only 6% say their EHR system features all the functionalities they believe are necessary.
AHRQ and CMS are collaborating to create a pediatric EHR template for children enrolled in Medicaid or the Children’s Health Insurance Program, Clancy said.
To design the pediatric EHR model, experts will conduct an environmental scan and gap analysis to identify up to three core functions for pediatric EHRs that currently are not available in most EHR systems. The new system likely will incorporate growth charts and vaccination data, Federal Computer Week reports.
EHRs for Other Groups
Howard Hays — acting program manager of the EHR system at the Indian Health Service — called for future EHR systems to assess uncommon factors that influence health status in certain communities, such as:
Hays said IHS’ EHR system already features software and standards that allow users to track information from nontraditional data fields, including some that address domestic violence (Lipowicz, Federal Computer Week, 6/4).
Leveraging EHRs To Address Health Disparities
Work group members also discussed the possibility of requiring health care providers to report how EHRs could reduce health disparities as part of the criteria for demonstrating “meaningful use” of health IT.
Paul Tang — co-chair of the work group and chief medical information officer of the Palo Alto Medical Foundation — said the second stage meaningful use requirements could require health care providers to leverage EHR data to address health needs for underserved populations.
Chris Gibbons, associate director of the Johns Hopkins Urban Health Institute, said health care providers could use EHR data to evaluate and monitor reductions in specific disparities (Mosquera, Government Health IT, 6/7).
Source: iHealthBeat
If health IT is to meet the challenges of a reformed healthcare system, the industry needs greater investment in health IT innovation, more integrated systems, and a focus on finding ways to enable patients to better manage their health, a Hewlett Packard executive says.
In an interview with InformationWeek, Harry Kim, HP’s director of enterprise business healthcare, argued that the United States is not driving the level of innovation needed to meet the new healthcare realities.
“We have the best medical technology, but our information technology to bring it all together is lacking investments. It lacks the structure inside the country to drive progress,” Kim said.
According to Kim, the healthcare industry currently invests more in medical technology than health IT, and the imbalance is having an impact on vendors’ approach to providing solutions in healthcare.
“When you compare IT investments with medical technology investments, IT always loses and what wins is medical technology investments in, for example, the latest MRI, CT scan, or mammogram equipment. With this medical technology you are essentially building expensive islands of information,” Kim said. “The lack of investment around information technology to bridge those disparate information sets together, that’s where the lack in investments has been,” Kim explains.
Kim’s observations are supported by a recent Dow Jones VentureSource report that revealed that venture capital investments in the medical software and information services segment dropped from 17 deals totaling $69 million in the first quarter of 2009 to eight deals totaling $53 million during the corresponding period in 2010, a 77% decline.
This lackluster investment climate occurred during a recession, but also at a time when the government signed into law the American Recovery and Reinvestment Act of 2009, which authorized $20 billion to assist in the development of a robust health IT infrastructure.
HP is closely working with federal and state authorities as the ongoing push to revamp health IT continues. For example, HP handles 35% of all Medicare and Medicaid claims in the United States and each year performs 2.4 billion healthcare transactions, including 1 billion healthcare claims.
Souce: InformationWeek Healthcare
A key government advisory panel on healthcare information privacy continues to wrestle with how much—if any—control patients should have over the use and movement of their electronic health records.
Patient consent for movement and use of records “is absolutely a part of this framework,” said Deven McGraw, chair of the Privacy and Security Workgroup of the Health IT Policy Committee. Still, patient consent should not be the linchpin of healthcare information privacy, she argued at the committee’s May 19 meeting, “because then you’ve asked the patient to bear that burden.”
The privacy and security work group made three recommendations to the committee:
Construct specific privacy and security-protection policies and technologies in all forms of electronic health-information exchange, and implement principles of the Nationwide Privacy and Security Framework for Electronic Exchange of Individually Identifiable Health Information, which was issued in the waning days of the George W. Bush administration.
Encrypt messages, even in one-to-one information exchanges, and limit potentially identifiable information used to identify patients and their records and in electronic communication.
Enforce these “strong” new policies so that there is no need for “any additional individual consent beyond what is already required by current law.”
The last recommendation would leave a lot of latitude for data-sharing without patient consent.
In December 2008, the Office of the National Coordinator for Health Information Technology at HHS issued its 12-page National Privacy and Security Framework , the plan the work group says should be implemented. It defines privacy not as a patient’s right to control the movement of his or her medical information, but rather as “an individual’s interest in protecting his or her individually identifiable health information.” In 2006, however, the National Committee on Vital and Health Statistics, in a list of 26 recommendations, defined health information privacy as “an individual’s right to control the acquisition, uses or disclosures of his or her identifiable health data.”
The role of patient control and consent—whether it is a right or merely an interest—remains unresolved. The issue is important because under a 2002 revision of the privacy rule under HIPAA, the federal government overturned the consent requirement in the original rule and provides “regulatory permission” for disclosure of patient information without consent for treatment, payment and a broadly defined catch-all category of “other healthcare operations.” Some states, whose more-stringent privacy laws pre-empt HIPAA’s provisions, still require patient consent for certain types of record-sharing, such as lab test results; some, such as New York, do so even for treatment.
McGraw said the work group began its discussions by focusing on consent but found quickly that consent “is just one piece of a bigger puzzle.”
Even if patients are fully empowered to make decisions about controlling the use of their medical information, she said, “Just what kind of a decision is that if there is a fair degree of uncertainty about how exchange is going to operate and who can access data and for what purposes?”
If consent were deemed to be “your one and only or most important protection, you might end up with individuals essentially bearing the burden of protecting their own privacy through the decisions that they make about whether to participate,” McGraw said.
For example, the ONC is supporting development of NHIN Direct, a lightweight version of the proposed national health information network.
According to McGraw, NHIN Direct contemplates peer-to-peer movement of patient information between providers, as in a computerized transfer of a referral letter from one physician’s electronic health-record system to another’s. In more-sophisticated forms of exchange, as in the transfer of data to a state or regional health-information organization, the risk of privacy loss is heightened from the patient’s perspective.
“We have such a plethora of potential (data-exchange) models out there that grappling with this from a policy standpoint is incredibly challenging,” McGraw said. “We don’t think what we have in current law today adequately addresses the activities of these exchange facilitators.”
And that, she said, “led to some great difficulty coming to some resolution on the issue of consent.”
McGraw said the work group adopted as a “touchstone” to guide their discussions what she described as the “Paul Tang principle,” which is, “What would a reasonable patient expect?”
McGraw said the principle was named for the physician informaticist and chief medical information officer of the Palo Alto, Calif., Medical Foundation, who serves as vice chairman of the Health IT Policy Committee and is a member of the privacy and security work group.
“One of the places where we quite often fall down is transparency,” she said. “Patients often don’t know what’s done with their data, who has access to it and for what purposes. There is a sense that, when you have that direct, one-to-one exchange, it’s more consistent with what the patient expects versus a more robust query/response system, creating separate databases, or lack of strong protections on what the entities in the middle can do with the data.”
In applying the Tang principle to these latter forms of exchange, McGraw said, “You can see where the patient expectation test is telling you, we’re straying into territory that is well beyond what many reasonable patients would expect and we have a responsibility to meet that with a strong set of policies in order to build trust and create a set of circumstance where what patients expect is in fact what we’re doing.”
Source: ModernHealthcare.com
Urgent care clinics and emergency departments are increasingly installing automated medication dispensing machines to address pharmacist shortages, particularly in rural areas, HealthLeaders Media reports.
In addition, the automated prescription dispensing machines can give pharmacy staff more time to interact with patients or work with more complex medications. The machines are not seen as a replacement to a pharmacist and typically do not dispense prescriptions that require regular refills.
One company, InstyMeds, has installed about 200 automated medication machines in urgent-care clinics and emergency departments throughout the U.S.
While interest in the technology appears to be increasing, some states regulate or prohibit the use of such machines (Bakhtiari, HealthLeaders Media, 5/11).
Source: iHealthBeat
The White House announced a shift in national drug policy that would treat illegal drug use more as a public health issue and plunge more resources into prevention and treatment.
The new drug-control strategy boosts community-based anti-drug programs, encourages healthcare providers to screen for drug problems before addiction sets in and expands treatment beyond specialty centers to mainstream healthcare facilities. President Barack Obama called the plan a “balanced approach to confronting the complex challenge of drug use and its consequences.”
His drug czar, Gil Kerlikowske, was more blunt. “Calling it a war really limits your resources,” Kerlikowske told reporters. “Looking at this as both a public safety problem and a public health problem seems to make a lot more sense.”
The plan—the first drug strategy unveiled by the Obama White House—calls for reducing the rate of youth drug use by 15% over the next five years and for similar reductions in chronic drug use, drug-abuse deaths and drugged driving. The new drug plan encourages healthcare professionals to ask patients questions about drug use even during routine treatment so that early intervention is possible. It also helps more states set up electronic databases to identify doctors who are over prescribing addictive pain killers. “Putting treatment into the primary healthcare discussion is critical,” Kerlikowske said in an interview.
Source: Associated Press
Mobile phone applications are increasingly being developed and tested worldwide to help bolster treatment options for mental health patients, NPR’s “Morning Edition” reports.
Several studies are being conducted in countries such as Australia, Ireland and the U.S. to explore how the computing power of mobile phones can help patients monitor moods, follow treatment recommendations and manage stress.
According to researchers, the mobile applications can provide new insight into a patient’s emotional variability and promote patient participation in therapy sessions.
The applications are being used to target certain conditions, such as depression and schizophrenia. Some researchers hope eventually to expand use of the technology to treat anxiety, phobias, eating disorders and other mental health issues.
The segment includes comments from:
Source: iHealthBeat
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