Before the benefits of this improved standardization can be realized, however, the entire healthcare industry —including payers and providers — must adopt the new standard on Jan. 1, 2012. While the journey to Version 5010 implementation will be different for every practice, there are some common activities in which all practices should engage in to support an effective transition:

• Creating an implementation plan Working with health information technology (HIT) vendors, billing services and clearinghouses to determine what steps need to be taken to make the transition to Version 5010

• Obtaining testing schedules from all HIT vendors and devoting staff time and resources to testing efforts

• Updating all necessary HIT software to recognize Version 5010

• Training staff on the transition to Version 5010, with special emphasis on billing staff

• Testing internal procedures and troubleshooting

• Communicating with major payers directly about their Version 5010 plans

• Testing your Version 5010 transactions with Medicare and your other major payers

• Monitoring operational data files to ensure solutions are working properly

A key component on this checklist is ensuring that your practice management and billing system software will be Version 5010 compliant by the implementation date. Practices that do not do this could experience claim rejections and significant disruptions in their cash flow. Practices can verify that their HIT vendors are prepared for the transition by asking:

• When will you be ready to transition to Version 5010?

• Will you be able to handle both Version 4010 and Version 5010 transactions?

• Will there be any software updates? If so, will there be a cost associated with them?

• When can my practice participate in testing with clearinghouses and payors?

• What tools and services will you offer to ensure no interruption to cash flow during the transition period?

In addition to increased standardization, Version 5010 also serves as a critical step in preparing for the transition to ICD-10, which is scheduled to occur in October 2013. Without a successful Version 5010 conversion, practices will not be able to move to ICD-10 because Version 4010 will not support the new codes. This underscores the importance of a systematic Version 5010 preparation process that involves both HIT vendors and payers.

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At a session during the MGMA 2011 Annual Conference, Oct. 23-26 in Las Vegas, Tennant will walk through current 5010 readiness, steps practices should take now if not prepared–like contracting with a claims clearinghouse if they haven’t already–and the possibility of some flexibility being attached to the compliance date.

Tennant doesn’t see the data being extended, but he does hope the government–and other payers–will show some flexibility. For instance, if a claim has enough data to be adjudicated, he hopes the claim isn’t rejected because it doesn’t have a piece of meaningless data. Tennant is cautiously optimistic that such flexibility will be shown. “It’s in nobody’s interest to have nationwide claims disruption.”

But physician practices shouldn’t be counting on an extension or flexibility, he contends. If a practice won’t be ready by January, it needs to start padding its cash reserves and getting a line of credit to meet financial responsibilities if some or all of its claims are getting rejected.

In addition to the 5010 migration, there are other looming initiatives that will have a large affect on financial and administrative transactions processing. Tennant will walk through such issues as ICD-10, health plan identifiers, claims attachments and operating rules. “If I can do one thing, it’s to give attendees a roadmap,” he says. “There’s a lot of things coming.”

Session C12: “ICD-10 and New HIPAA 5010 Transaction Standards,” is scheduled at 3:45 p.m. on Monday, Oct. 24. More information is available at mgma.com.

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The switch from the current 4010A1 format to the new 5010 format requires substantial changes to the claims information you submit. It is extremely important that you are aware of these HIPAA changes and take the necessary steps to be in compliance by the January 1 deadline. If these changes are not made, payers may not be able to process your claims.

The Centers for Medicare and Medicaid Services (CMS) mandate includes upgrading the current electronic transaction standard for health care claims, remittance advices, eligibility and claims status to X12 version 5010. Since the changes cover the data you submit with your claims as well as the data you receive in response to your electronic inquiries, implementation may require changes to the software, systems and procedures you use for billing your transactions.

Gateway EDI is here to help you through the 5010 conversion process. From helping test your claims to providing strategies to minimize the impacts to your practice, we are ready to ensure that your practice’s transition proceeds seamlessly and on time.

To assist you with planning a smooth transition, some of the following CMS guidelines outline questions to consider with your team. These steps will help identify actions for your office to take prior to the transition, plans for coordinating with your software vendors, clearinghouses, billing services, and payers, and impacts on your practice’s data reporting requirement changes, workflow modifications and testing.

Talk to your software vendor early: Your software vendor is the company that supports your practice management system. You will need to contact them to determine what version you are currently using and what you will need to be 5010 compliant. Questions to consider asking:

• Will you be upgrading your current system to accommodate Version 5010 transactions?
• What is the time frame for when you will be able to support Version 5010 transactions?
• Will you be able to support both Version 4010A1 and Version 5010 transactions at the same time?
• When will upgrades be available?
• Will there be a charge for upgrades or will my current charges increase?
• When will software installations be completed for Version 5010?
• If there will be an update to our system, what fields are being added or changed?
• What business processes will be affected by 5010?

Identify changes to data reporting requirements: Data reporting requirements and questions for your own team to consider include:

• What data reporting changes will affect the transactions we use?
• What resources can we use to help us identify the data reporting changes? Will there be a cost?
• Can the new data be stored in our office’s current system or will it require a system upgrade?
• If our software vendor stated that there will be an update to our system, what fields are being added or changed?
• How do these changes fit into our existing operations?
• Will we need to purchase additional hardware for the new reporting requirements?
• Based on data changes needed for our practice, does anyone in our office need to be trained on workflow changes?
• Which requirements for testing 5010 transactions are relevant to our work?
• What kinds of transactions do we need to have tested?
• Do our vendors’ testing plans cover all of our needs?

Talk to your trading partners: Trading partners include all organizations involved in the end-to-end exchange of electronic health care data and transactions, such as payers, providers, clearinghouses, billing services, network service vendors and data transmission services. If you utilize a billing service, you need to contact them to determine their plan for 5010. If you send claims directly to any payers, you will need to contact them. To learn more about Gateway EDI’s transition plan, visit www.gatewayedi.com/5010.

To help you plan these conversations, questions to consider asking your trading partners include:

• Will you be upgrading your systems to accommodate 5010 transactions?
• When will each of the upgrades be completed?
• Will there be additional fees for these upgrades?
• Do the upgrades require changes to the way we work with you today?
• When can we test for 5010 to ensure the system works properly?
• Do you have connections to multiple trading partners and will you be testing with all of them?
• Do we need to use test data or live data during testing?
• What are your requirements for testing 5010 transactions?

Plan your next steps: Testing is a very important part of the transition to 5010. Gateway EDI is here to help with testing your claims and every stage of your 5010 transition. For answers to common questions about the transition and testing for 5010, please visit http://www.gatewayedi.com/5010/faq/.

It’s also a good idea to talk with your peers about the changes they have to make and what they are doing to prepare. Check with the industry associations you belong to for upcoming discussions and events.

The following resources also offer assistance regarding the 5010 transition:

• CMS Side-by-Side Comparison Documents for the 5010
  www.cms.gov/electronicbillingeditrans/18_5010d0.asp
• Washington Publishing Company – purchase the 5010 Implementation Guides
  www.wpc-edi.com
• The American Medical Association (AMA) – 7 Steps Practices Can Take Now to Prepare for 5010
  http://www.ama-assn.org/ama1/pub/upload/mm/399/5010-seven-steps.pdf

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The “Annual Report to Congress on HIPAA Privacy Rule and Security Rule Compliance For Calendar Years 2009 and 2010″ summarizes compliance with HIPAA, complaints received by HHS of alleged violations of the HITECH Act or HIPAA rules and HHS’ responses to complaints.

From April 2003, the compliance date of the HIPAA Privacy Rule, to Dec. 2010, the most common compliance issues with the Privacy Rule that the OCR investigated were the following, in order of frequency:

1. Impermissible uses and disclosures of PHI.
2. Lack of safeguards of PHI.
3. Denial of individuals’ access to their PHI.
4. Uses or disclosures of more than the minimum necessary PHI.
5. Inability of individuals to file complaints with covered entities.

From April 2005, the compliance date of the HIPAA Security Rule, the most common areas for which entities failed to demonstrate adequate policies and procedures or safeguards, as required under the HIPAA Security Rule, include the following, listed by frequency:

1. Response and reporting of security incidents.
2. Security awareness and training.
3. Access controls.
4. Information access management.
5. Workstation security.

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SecureGRC SB HIPAA compliance toolkit simplifies HIPAA/HITECH compliance management for small medical practices.

GRC Challenges for Healthcare

• Mandatory for companies that process, store or handle personal health information
• High costs of defining controls for IT
• High costs of demonstrating IT Compliance
• Budget impact to IT efforts for business
• Allocation of resources away from key business initiatives
• Difficulty with ongoing sustainability
• Companies with wide range of capabilities and resources have similar requirements

Examples of SecureGRC’s out-of-the-box compliance reports for satisfying audit requirements include the following:

The software platform provides certain key functions that help the overall process, such as:

• Decrease the time to get and stay compliant thus reducing costs associated with the compliance processes
• Cloud based “pay –as – you –grow” delivery option- Provides ‘Software as a Service’ (SaaS) model with on-premises deployment or a completely on-demand cloud based service, requiring very low initial investment with high returns; also ideal for small and medium businesses
• Centralized dashboard view of the compliance status drilling down across departments, geographies, etc; generation of reports to demonstrate compliance for any regulatory or standard based audits
• Provide for Workflow, Document Management, Controls Inventory, Compliance Scanner, andfine-grained access control through a secure Web based interface
• Compliance Scanner scans and integrates compliance related information from various multiple sources and matches them against “Compliance Signatures”.
• Manage exceptions and activities related to compliance; provide reminders to people for addressing compliance related tasks in an optimal manner
• Provide an exhaustive audit trail for all compliance related actions in the whole process

The software platform provides certain key functions that help the overall process, such as:

• Decrease the time to get and stay compliant thus reducing costs associated with the compliance processes; address and adapt to the constantly changing regulatory landscape
• Cloud based “pay –as – you –grow” delivery option- Provides ‘Software as a Service’ (SaaS) model with on-premises deployment or a completely on-demand cloud based service, requiring very low initial investment with high returns; also ideal for small and medium businesses
• Centralized dashboard view of the compliance status drilling down across departments, geographies, etc; generation of reports to demonstrate compliance for any regulatory or standard based audits
• Provide for Workflow, Document Management, Controls Inventory, Compliance Scanner, andfine-grained access control through a secure Web based interface.
• Compliance Scanner scans and integrates compliance related information from various multiple sources and matches them against “Compliance Signatures”.
• Manage exceptions and activities related to compliance; provide reminders to people for addressing compliance related tasks in an optimal manner
• Provide an exhaustive audit trail for all compliance related actions in the whole process

HIPAA Compliance Manager Specifications

	Exclusive customer instance of SecureGRC:Each customer on the cloud will have an exclusive instance of the application running ensuring complete security of client data
	Single and centralized repository for all compliance related data: Supports storing all relevant documents, evidences, processesrelated to compliance in one place with access to itfrom anywhere and at anytime; organize documents in a hierarchy –whether by geography or department or regulation.
	Display questionnaires to evaluate manual controls: In-built questionnaire generator for use predefined or customized questionnaires. Supports email notifications setup on a schedule to collect information from people.
	Dashboard and reports: Predefined or customized graphs creation facility by the user. The charts have the ability to drill down to the underlying data when clicked.Also, reports that can be exported to CSV, PDF etc can easily be generated, through online interfaces.
	Remediation tracking: Tracking issues or “action items” that are either automatically detected or manually found in the compliance management software process and remediating through feature-rich remediation module. Items can be assigned to individuals or groups, approved by their managers, fixed, and closed online.
	Compliance activity email reminders: Define workflow once in terms of roles and responsibilities and facility to attach documents and provides exhaustive audit trail of actions related to the workflow.
	Track credit card or sensitive data within databases, file systems, desktops, and servers: Compliance Scanner will search for Credit Card (Track, PIN, CVV) data in Filesystems, Shared drives, Databases, Removable hard drives etc.
	External vulnerability scans: on-demand and scheduled run of external vulnerability scanning for external IP addresses.
	Analyze firewall rule sets: Automatically gather information from various supported systemsand mapping against the relevantregulations or standards based on one-time setup and scheduling.
	Perform vulnerability scans and integrate with existing vulnerability scanners: Gatherinformation from Network vulnerability scanners (suchas Nessus) and External ASV scans and automatically map them to the relevant regulations.
	Integrate with web application scanners: Gather information from Webapplication vulnerability scanners and automatically map them to the relevant regulations.
	Compare user access for appropriateness: compare and check access rights of users and whether they belong to groups thathave the appropriate rights for access. Any discrepancies can then be flagged and marked asnon-compliant through the use of “Compliance Signatures”.
	Test password strength of domain and databases: Continuously monitor password strength settings such as alphanumeric requirement, expiry upon 60 days, account lockout etc. within target databases and operating systems in scope. These settings can be configured to match up with PCI DSS requirement 8 for password strength.

Contact us

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The survey results confirm what Oracle and Deloitte, who commissioned the survey, are seeing in the marketplace, attendees were told at a healthcare session at Oracle OpenWorld Conference on Wednesday.

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“Clicking through a database to provide exactly the type of data requested is very time consuming and arduous,” he writes. “It takes physicians’ attention away from patients in most instances, and may not add as much to the readability of a medical record as might be requested.” 

In contrast, using speech recognition software allows doctors to maintain eye contact and minimize attention paid to a computer screen. The technology, however, is not without its glitches, as it can be difficult to use with mobile EHR systems, a major reason why mobile technology is used more for data viewing as opposed to data input.

Fishman recommends that physicians review their voice recognition-generated notes and make corrections as required. They also should consider using voice recognition, not for an entire patient record, but in combination with a drop-down list and then dictating a few sentences of a patient’s history in their own words. 

To learn more:
- read the Medscape Business of Medicine article

According to the study, those patients in physician practices that used EMRs were significantly more likely to have care that met certain standards as well as positive outcomes than those in physician practices that used paper records. Standards included timely measurements of blood sugar, management of kidney problems, eye examinations, and vaccinations for pneumonia. Positive outcomes included meeting national benchmarks for blood sugar, blood pressure, and cholesterol control, as well as achieving a non-obese body mass index and avoidance of tobacco use.

Almost 51 percent of patients at EMR-based practices received care that met all of the endorsed standards—compared to only 7 percent of patients at paper-based practices. And almost 44 percent of patients in EMR-based practices met at least four of five outcome standards—compared to just 16 percent of patients at paper-based practices. According to the study, these findings were consistent regardless of insurance type (Medicare, Medicaid and commercial payers) as well as for the uninsured.

David Blumenthal, MD, former National Coordinator for Health Information Technology, says these results support the expectation that federal support of EMR’s will generate quality-related returns on investment (ROI).

Breach reporting has become an intrinsic and important element of the HITECH Compliance regulations. All data breaches crossing over 500, are required to be reported to the HHS within 60 days, while data breaches under 500 can be submitted annually. These breaches although not published by the HHS, they are compiled and sent to congressional committees as per the HITECH stipulations. With data breaches resulting in not just penalties but also the erosion of precious reputation and image of different health care providers, it is time that health care providers take efficient compliance measures to abide as per HIPAA and HITECH regulations effectively.

The idea is to work smartly and bring about complete visibility with an effective and economical security solution as far as safeguarding of security of patient’s health information is concerned. Most small health care practitioners worry about the investment aspect involved in installing compliance solutions, but here is eGestalt’s SecureGRC SB, which is an ideal solution especially for small medical practices. A one-stop solution, it allows health care providers to abide as per the compliance regulations of HIPAA/HITECH.

A web-based solution, SecureGRC SB offers a unique approach to tackle security and data breach issues. Owing to its ability to deliver services on the cloud, it can capture information and keep you updated constantly in case of any changes in regulatory policies. SecureGRC SB is an economical, easy to use web based solution that can help small medical practitioners be HIPAA Compliant. It is high time that small healthcare practices opt for a suitable compliance healthcare solution to tackle data breaches intelligently and make data breaches a thing of the past.

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“Glidepath” is a project management technique that ensures there will be time to detect and repair problems as the project comes to completion. Visualize an airplane landing down a long runway versus an abrupt landing on an aircraft carrier. Long runways allow for less expert pilots and less chance of large failures. There should be a way to ease into the new software without putting anyone at risk. Having no glidepath means each surprise and mistake becomes much more severe.

For simple projects, there may not be a glidepath considered in the plan, but the project is likely to succeed anyhow. However, whenever the consequences of failure are severe or when the project is complex and interconnected, then staging a glidepath is critical.  

We find this scenario with both 5010 and ICD-10 at the extreme; yet, there is little true glidepath planned with 5010 and none with ICD-10. 

The problem is not that we were not given enough time to succeed. The official lead times for 5010 and ICD-10 have been years. Organizations have had time to take this effort seriously and get their portions completed. However, there is potential problem coming for provider organizations that is out of their control. 

The root of the problem is consequences for failure (snafus) and the incentives to be ready ahead of the deadlines do not converge. Focusing on insurance claims, there is no planned incentive or mandate for insurance payers to be ready ahead of the final deadline; yet, the consequences of any mistake fall to the provider organizations (with clearinghouses caught in between). 

In 5010, an entire year was given for payers to test their systems, but there is nothing in the plan that prevents an insurance payer from beginning to accept 5010 claims near (or even after) the deadline. This will not leave much (or sometimes any) time for providers to have real claims pass through the payer’s adjudication system. If problems are found, providers will not be allowed to rely on 4010 style claims. Payers are likely to reject 4010 claims even if problems are discovered with their own system or with the provider’s claim submissions. Providers will be caught with no glidepath and may bear the financial brunt, even though they could not influence when the payer would be ready.

For ICD-10, the situation is even more extreme. The ICD-10 regulation will have broader and deeper impact than the 5010 regulation; yet, only a single day is scheduled for every healthcare related entity to come together at once. This is a crash landing scheduled right into the plan. When problems arise, every organization in the circuit will be affected, with providers at highest risk losing a large percent of revenue. The regulation is counting on all of this to work right the first time it is turned on, which should be a red flag warning to us.

The solution for regulations similar to 5010 and ICD-10 is to allow for a transition period for the provider organization after the insurance payer is live with its portion. This would mean giving provider organizations a time window (say, four months) from when a payer is live, before the payer would require ICD-10 diagnoses on claims. Providers would be allowed to send small targeted claim batches during the four month window in order to test the payer’s system and respond to the results. For 5010, this is exactly what is needed. For ICD-10, the story is more complicated, but the essential suggestion would be to establish more glidepath.

In future regulations, sensible accommodations for glidepath would allow for problems to be experienced and corrected before large numbers of claim rejections or denials put the provider organization at risk. This is one additional precaution that can be taken to reduce severe risk as thousands of organizations try to transition into these very important, but complex, regulations.

Phil Dodds has been designing practice management software for 16 years with gloStream, Sage, and Medical Manager.

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Melanie Endicott, manager of professional practice resources at the American Health Information Management Association (AHIMA), also agrees that now is the time to be moving forward with ICD-10-CM/PCS planning and implementation. 

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You can implement various billing-function improvements to involve the entire staff in the billing process and streamline your workflow for faster reimbursement turnaround and a more efficient practice.

Emphasize front-end billing
-Create a collection policy that outlines the timeframe for past-due patient accounts. For example, mail statements to patients in 30-day intervals with phone calls to remind them of overdue bills in between. Once 130 days have passed, send an account to a collection agency.

-Conduct billing audits for front office staff. The Physician Billing Process: 12 Potholes in the Road to Getting Paid provides a sample front-office audit tool with a list of assessment questions for each stage of the patient billing process: pre-visit, patient check-in/reception and entry charge. Questions include:

• Do you maintain a current list of insurance plans and critical plan elements to ensure compliance?
• Do you have a policy regarding the steps to take if a patient fails to pay?
• Is charge entry conducted within 24 hours of date of service?

Develop your staff’s payer-specific knowledge
Ensure that your whole staff, including clinical and front office personnel, knows which insurance companies your practice accepts.  This information is crucial for front office staff so they can book appointments appropriately, obtain waiver forms and collect time-of-service payment of co-pays.

Define expected workload ranges
This graph shows examples of time recommended for billing staff to spend on various tasks:

Source: The Physician Billing Process: 12 Potholes to Avoid in the Road to Getting Paid

Link complementary work functions
To minimize work handoffs, assign billing tasks by account. This way staff members work on a case from beginning to end and it’s easier to locate the source of errors.

One practice administrator recently explained in the MGMA Member Community that she splits her practice’s billing workload alphabetically among her billing staff, rather than by each task. Instead of having one staff member do the coding, one do the charge posting, etc., each billing staff member is cross-trained on all billing and collections functions. Read the member-only thread here.

Prepare for new payment models
MGMA members cited “preparing for reimbursement models that place a greater share of financial risk on the practice” as the No. 1 challenge in this year’s member-only Medical Practice Today: What members have to say research.

This includes accommodating potential Medicare reimbursement cuts of up to 29 percent, as well as changes in fee-for-service to fee-for-performance models. How will that affect your billing front office and clinical staffs’ workload and priorities?

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HIPAA requires the U.S. Department of Health and Human Services (HHS) to
adopt required standards for covered entities to use when conducting certain
health care transactions electronically, such as claims, remittance advices, and
requests and responses for eligibility and claims status. The current transaction
standard is X12 version 4010A1. The Centers for Medicare & Medicaid Services
(CMS) has mandated that the industry upgrade to X12 version 5010. The new
standards will increase transaction uniformity, support pay-for-performance,
streamline reimbursement transactions and support ICD-10 CM codification.

What is gloStream Doing About the ANSI 5010 Conversion?

gloStream understands that the 5010 mandate is a complex industry change
that has a direct impact on how quickly practices get paid. We’re working hard
to make sure that all of our practices are prepared and that the transition is
seamless. We’ve created functionality within our software that allows practices
to turn on 5010 criteria with a single click so that 5010 claims and eligibility
requests can be generated quickly and easily.
gloStream and ANSI 5010

Success Stories

“Having finished all development work, which includes successful ANSI 5010
testing with current clients, gloStream is well ahead of the pack.  They are
100% ready for the ANSI 5010 conversion and committed to ensuring their
clients can always submit their claims successfully and get reimbursed quickly.”

Jackie Griffin
Manager of Training and 5010 Project Implementation
Gateway EDI

“gloStream has made preparation for the ANSI 5010 conversion really easy.
In fact, we’ve already sent test claims successfully through Gateway EDI. The
process was painless and a lot easier than I anticipated. We sent our claims
and twenty minutes later were alerted that they were approved. I’m really
pleased to be working with gloStream, a vender that is prepared for the
5010 changes.”

Lisa Tidwell
Office Manager
Practical Pediatrics (Texas)

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With 2011 marking the 15th anniversary of the Health Insurance Portability and Accountability Act, health care providers and IT companies continue to evaluate how to keep electronic health data secure.

On Aug. 21, 1996, President Clinton signed into law a set of rules detailing who can access personal health information. Under HIPAA, health information may not be disclosed without a patient’s consent unless disclosure is necessary to administer benefits, payment or health care.

Under HIPAA, providers must regularly disclose privacy practices to patients, and parties must also disclose information to the Department of Health and Human Services if they’re under investigation.

“It does give patients rights to their records and the rights to know who’s seen their records, and that’s important,” John Moore, an analyst at Chilmark Research, told eWEEK. The law doesn’t tell hospitals what to do with the data, however, Moore added.

HIPAA has also influenced the passage of the Obama administration’s 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act, which made penalties for data breaches more severe. Data breaches can now cost companies up to $250,000, Moore noted.

The 2009 HITECH Act widened the scope of privacy protection under HIPAA following criticism that the privacy laws had not been rigorously enforced, according to Amit Trivedi, health care program manager for ICSA Labs, a division of Verizon. ICSA tests electronic health records (EHRs) to see if they satisfy federal mandates on meaningful use.

Under HITECH, “business associates,” or third parties such as a billing company or cloud provider, now must follow the HIPAA privacy laws by protecting patient information and reporting data breaches, Mike Gleason, director of information services at Scottsdale Healthcare, in Scottsdale, Ariz., told eWEEK.

“That wasn’t as clearly spelled out in the initial HIPAA law but was in HITECH provisions,” Gleason said.

Concerns about HIPAA rules have resulted in some companies avoiding the health care IT space altogether, according to Moore.

“You need to jump through hoops to make sure a solution is HIPAA-compliant,” Moore said. “So some companies say we’re just not going to go there, particularly now that they’ve strengthened HIPAA rules and [implemented] big penalties for those that have violated HIPAA.”

In addition, the hospital system conducts annual threat assessments and tests to ensure that the network remains secure and to guard against unauthorized access, Scottsdale Healthcare’s Gleason said.

“Security is a layer that needs to be there, it needs to be stringent, and it needs to be adhered to, but it cannot be an obstacle in providing information,” he explained.

HIPAA laws have brought a greater awareness for health care providers that data security is important, Gleason said. The privacy laws have impacted the agenda of Scottsdale compliance committee meetings and have made hospital employees more careful as far as how they communicate with one another and have led to increased auditing of who’s viewing data records.

“I think there’s much more awareness, not only in our employee population but also our patient population,” Gleason said. Awareness of HIPAA laws means “you can’t just kibitz with your co-worker,” he added.

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Later this year, the Department of Health and Human Services is expected to start auditing up to 150 health providers at random through December 2012 in an effort to find medical entities that fail to comply with HIPAA and HITECH regulations about how personal data must be handled securely.

Audits
While the audits don’t represent attacks on the personally identifiable information (PII) the regulations are supposed to protect, they do expose non-compliant providers to the potential for heavy fines and reputation-damaging publicity.

For instance, earlier this year Massachusetts General Hospital paid $1 million to settle a patient-privacy complaint with HHS due an employee leaving patient records in a subway car.

That’s a big switch from the way healthcare privacy regulations have been handled since 2003, says Abner Weintraub, president of HIPAA Group, a compliance consultancy to healthcare organizations. Until this year, HHS had received about 50,000 complaints but levied no fines, preferring to take remedial actions instead, he says.

Fines
Levying fines now has an upside for HHS, says Kelly Hagan, a healthcare attorney with law firm Schwabe, Williamson & Wyatt in Portland, Ore. – the agency gets a cut of whatever fines are levied. That, combined with the pro-active auditing, marks a sea change for what healthcare CIOs and CISOs face when dealing with HIPAA. “Suddenly HIPAA has teeth and is willing to bite,” Hagan says.

Despite this, instances of healthcare data breaches continue to flourish. Just this week, it was revealed that emergency room records from Stanford Hospital in Palo Alto, Calif., were posted for most of a year on a Web site where students can hire help to do schoolwork.

Last year, HHS received 207 reports of breaches involving more than 500 individuals, according to areport to Congress last week. And there are growing incentives for criminals to focus on health record theft, Weintraub says. Patient data can be sold to criminals interested in perpetrating identity theft, he says, but more lucrative are schemes to commit medical identity theft.

That’s when stolen patient data is used to obtain medical care for someone else, which not only bilks insurers but also taints the medical record of the individual whose identity is stolen by inserting records of treatments and tests the victim never received.

Think like a Bank
Medical organizations need to think of themselves not as repositories of neutral data but as protectors of valuable assets, he says. “Rather than a library, they have to think of themselves as running a bank,” he says, and that may include using security cameras and guards to defend certain medical records.

While some of the challenges healthcare IT executives face are technical. Many medical applications, by nature, require low latency and sharing of PII. So the network environment makes it somewhat hard to apply security controls, such as firewalls, which can slow things down and create performance issues for imaging applications, says Jeff Bills, vice president of IT at Solutions Healthcare Management, a consultancy and technology provider headquartered in Indianapolis.

People, Process, and Controls
But many of the security issues have to do with people. Data breaches may be the fault of staff or of business associates working on behalf of a healthcare provider, says Amit Trevedi, healthcare program manager at ICSA Labs. “Data breaches are often a result of breakdown of processes and controls, or lack of them altogether,” he says.

In talking to his clients, Bills warns about employees as a risk. “What we try to drill into them is that you can put up all the firewalls, anti-malware and intrusion prevention you want for the outside of your network, but you are your own enemy on the inside of your network,” he says.

While it falls outside the traditional purview of IT executives, training of staff and creating an atmosphere of privacy must be addressed to meet HIPAA regulations. Policies and procedures for dealing with PII are essential, Weintraub says.

That requires the help of healthcare executives and human resources departments, says Susan Patton, a healthcare attorney with Butzel Long in Detroit. “There’s a limit to what IT can do when the problems are really caused by human mistake,” she says. “It’s hard to fix human nature with IT.”

Culture of Confidentiality
She advocates creation of a culture of confidentiality. “Privacy must be seared into that part of the brain used for dealing with the patient,” she says.

Which is pretty much what HIPAA calls for, Weintraub says. The policies and procedures that the law requires healthcare organizations to write must also be taught to employees in a way they can understand and put in practice, he says.

Meanwhile, the IT staff should focus on general security best practices that are applied in all industries rather than trying to craft practices to satisfy HIPAA, because the two overlap greatly he says. “If you’ve done everything you should be doing anyway to protect your network and data, you’re going to be largely compliant with HIPAA from the get-go,” he says. “The challenges are still the same old set of vulnerabilities and ignorance.”

Original Article here…

Don’t delay any further, contact iTelework at (888) 673-6683 and speak to a Healthcare Professional, today!

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Roughly 83 percent of office-based physicians could qualify for federal incentives if they meet meaningful use criteria, according to a study published in Health Affairs. The study—which used data from the 2007 and 2008 National Ambulatory Medical Care Survey to measure the use of EMR systems by office-based physicians—found that some physicians would qualify for Medicare incentives, some for Medicaid incentives, and some for both. Eligibility was based on the number of Medicare and Medicaid patients seen.

Interesting data points from the study include:
–70.5 percent of physicians are eligible for incentives, but do not have a basic EMR.
–12.1 percent of physicians are eligible for incentives and already have a basic EMR.
–14.6 percent of physicians are not eligible for incentives and do not have a basic EMR.
–2.8 percent of physicians are not eligible for incentives and already have a basic EMR.
–Location matters: Midwest physicians were more likely to qualify, Western physicians less likely.
–Specialty matters: Psychiatrists are significantly less likely to use EMRs than other specialists.
–Practice type matters: Physicians in a solo practice and physicians in practices owned by a health maintenance organization (HMO) are less likely than those in larger practices to qualify for incentives and use EMRs.

While physicians may be slow to embrace EMRs, they won’t resist for long, according to Susan Dentzer, editor-in-chief of Health Affairs. Dentzer predicts more physicians will adopt EMRs from 2013 through 2015, in the final years of the HITECH bonus period. Moreover, as younger physicians begin practicing, the operating standard will likely change to using EMRs.

Don’t delay any further, contact iTelework at (888) 673-6683 and speak to a Healthcare Professional, today!

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–Work with experts. Seek out and work with a company that’s mastered the implementation process. You don’t want to be, and shouldn’t be someone’s test case. gloStream and our nationwide community of technology partners have helped hundreds of doctor’s successfully implement EMR systems.

–Choose Microsoft-based products. At gloStream we believe strongly that Microsoft-based products are the most familiar and easy to use and therefore the very best for practices. Also consider that Microsoft products are supported by hundreds of thousands of technology partners worldwide.

–Understand that a medical practice is not an extension of a hospital. Your practice will have different EMR needs than the local hospital – so don’t just duplicate what the hospital does. Choose a system that’s right for you, not somebody else.

–Choose an EMR that can be tailored to fit your specific needs. It’s crucial that you choose an EMR that can be personalized to the individual needs of the staff in your practice. Remember that no doctor practices medicine exactly the same so your EMR must be flexible. At gloStream we leverage Microsoft Office applications such as Word and have created what many believe to be the most flexible EMR available anywhere.

–Understand that change can be uncomfortable. Moving from paper charts and paper-based processes could cause you to be uncomforable. Embrace change and realize that after you implement your EMR you’ll be more productive and efficient, and much more at ease. This is a process. Remember that.

Choosing and implementing an EMR system is a big deal. For many practices, in fact, it’s the first time that they are using technology. Take the time to study best practices and understand how to be successful. You’ll be glad you did!

Don’t delay any further, contact iTelework at (888) 673-6683 and speak to a Healthcare Professional, today!

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5010 Tips

Provider Actions

The most widely recognized change in the 5010 Electronic Data Interchange (EDI) architecture is the version indicator that allows EDI transactions to differentiate between ICD-9 and ICD-10. This is only a small part of the reason that implementing 5010 is crucial to any organization’s overall ICD-10 plan.

There are over 850 specific changes in 5010; many of these changes correct deficiencies that are found within the current 4010A EDI standard. Additionally, 5010 will be able to aid covered entities by reducing transaction costs, minimizing manual processing, and reduce staffing needs, as well as seeing the introduction of additional features and new functionality. As a result, Gartner Group did a cost benefit analysis stating the industry could see between $11.6 billion and $33.8 billion in increased revenue from the 5010 migration alone. Here are some tangible benefits that migrating to 5010 will offer:

• Improved clarity in provider loops (or fields)
• ICD-10 support
• Clarified National Provider Identifier (NPI) instructions
• Requirements for guarantor/dependent information on eligibility responses
• Improved Coordination of Benefit (COB) transactions by telling payers which transactions is primary vs. secondary, enabling correct provider payment on initial submission
• Reductions in “syntax error”-related denials
• Improved tracking
• Multiple identifiers will be allowed
• Responses will be limited to the claims where an inquiry is made
• 45 new service type codes will be introduced
• Greater ease of use for eligibility transactions (specifically the 270 and 271 eligibility responses)

Ease the transition to 5010 by creating a well-designed and high-level supported project plan to guide the implementation team. It is imperative that the project plan allow for the unexpected. Changes of such magnitude typically require more work than we expect. 5010 is largely an IT infrastructure change, and we all know that the unexpected can occur in life, and especially with computer/system changes. Make sure the 5010 project plan has enough room built in for unexpected delays and setbacks that will surely crop up.

5010 is not simply a software update. The effort needed to properly implement 5010 will be considerable; do not make the mistake of thinking that 5010 is only a vendor/software issue. Business processes, business intelligence, budgeting and even staffing changes are only a few areas where additional focus may be required. Organizations that leave their 5010 implementation plans solely in the hands of their vendors will be in trouble in 2012.

Do not expect a regulatory pushback. If you are one of the many organizations waiting with bated breath that the Department of Health and Human Services is going to push back the 5010 implementation deadline, you are going to have a long wait. The biggest evidence of this is that the Centers for Medicare and Medicaid Services (CMS) is about to commence testing in April, 2010 of its 5010 systems. Non-compliance of this HIPAA-mandated change is punishable by fines, minimum $100 per transaction up to $50,000 a year annually, per transaction.

Engage vendors now. Early identification of all vendor systems and a thorough review of all applicable vendor contracts are paramount to the success of 5010 implementation. If vendors are going to charge more for this regulatory update, or if there are any additional fees, organizations need to know sooner rather than later. In addition, if vendors are still saying that they do not have a plan in place, or seem to be stalling, a vendor change may be necessary. The earlier vendors are contacted, the better for the overall success of an organization’s 5010 implementation plan.

5010 is an HIPAA-mandated standard change, and it is vital to the overall success of ICD-10-CM/PCS implementation. Equally important, but less recognized, is the fact that 5010 has the potential to save the health care industry billions of dollars. There are significant challenges, and it will not be easy. But in its own right 5010 will help our country usher in a new era in health care documentation, data exchange and delivery. These will benefits us all.

Don’t delay any further, contact iTelework at (888) 673-6683 and speak to a Healthcare Professional, today!

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Original Article here…

The survey information was released just as the registration period for the Medicare and Medicaid EHR Incentive programs opened, so if you’re considering EMR software, now certainly is the time. High rates of adoption and meaningful use could result in as much as $27 billion in incentive payments over 10 years, the organization reports.

According to ONC, the survey numbers represent a “reversal of the low interest” of previous years and credits leadership in the medical community and the federal government for driving interest. ONC execs say “we are seeing the tide turn toward widespread and accelerating adoption and use of health IT.”

For those of you already reaping the benefits of an EMR system, you’re part of a fast-growing and wise demographic – the number of primary care physicians who have already adopted basic EHR has risen 50% from 19.8% in 2008 to 29.6% in 2010. (Though reports indicate a basic EMR system does not necessary entail “meaningful use” and would likely need expansion to qualify.)

Based on the American Recovery and Reinvestment Act of 2009, healthcare providers can register their intent to achieve meaningful use of EHR technology, and under both Medicare and Medicaid, eligible hospitals could receive millions of dollars for implementation and use. Individual practitioners could receive as much as $44,000 for Medicare and almost $64,000 from Medicaid.

At gloStream, we want to continue playing an integral role in the growth of this industry and help as many practices as possible reap the benefits of an EMR, as well as take advantage of strong government support and the financial incentives to get your practice’s conversion to electronic medical records underway. We’re here to help you evaluate your options and ultimately customize the right EMR for your practice. Let us help you better your practice’s day-to-day operations, and the bottom line, to boot.

1. Up to $44,000 in stimulus money from Medicare. This money can be collected over a 5 year period, with $18,000 being available the first year to physicians who meet meaningful use standards.  $44,000 is available for each physician, it is not per practice money.

2. Up to $63,750 in funds from Medicaid. These funds can be collected over a 6 year period with $21,250 available the first year to physicians who are working toward installing an EMR system. This funding is also available for each physician.

3. Avoiding penalties. Penalties will be issued starting in 2015 for Medicare physicians who have not adopted EMR software by that time and are not meaningful users. Starting in 2015 the Medicare fee schedule will be reduce by 1%, with 2% and 3% reductions to follow in 2016 and 2017 respectively.

Thanks to the ARRA, there’s never been a better time for doctors to make the switch from paper records to EHR software.

I’ve removed the name of the writer and the names of the vendors. Plus, realize that it was written originally in an email communication and not necessarily to be published.

OMG…you hit the nail on the head with this post. Our EMR is so slow. It often takes minutes between pages. My clinical and front office staffs so frustrated. We have had nothing but finger pointing going on ever since.

Part of the issue is the interface between our practice management system VENDOR A and our EMR VENDOR B It takes a minimum of 3-4 minutes for data entered into VENDOR A to roll into VENDOR B. My front office staff has taken to entering the data twice, once in each program in order to get our patients registered timely. When you see 80-100 patients in a day, a few minutes makes all the difference.

Additionally, certain criteria does not roll over, namely email addresses. This makes it impossible for us to send out patient visit summaries thus we are unable to meet meaningful use for that criteria. Referring physician is another part that does not roll over.

The most frustrating part is that no one will take any responsibility for the issue much less work on fixing it. These two vendors spend all day playing the blame game. Fortunately for our practice, we have a wonderful IT company that we work with. Our IT specialist has spend countless hours trying to mediate between these two vendors. Most times he just fixes what he can but we are paying for his services in addition to the tech support agreement with VENDOR A and VENDOR B.

A perfect example happened this week when the EMR went down in one of our exam rooms.. First we spend at least 10-20 minutes on hold waiting for a VENDOR B tech to pick up the call. In this particular case, they worked remotely for at least 4 hours on this one computer only to tell us they could not fix it.

I called my IT guy and he fixed it within 10 minutes. My staff spends countless hours on the phone most days trying to keep the system up and running. We are in the process of replacing all our PCs and I recently upgraded our Internet to a 10×10 fiber service however we still are not seeing any difference in speed.

It is at least comforting to know we are not alone. I plan to hang up your post for all my staff to see. It may not make our system work faster but hopefully it will give them some comfort knowing they are not alone.

Thanks for all the great information.

Full Article here…

Related Articles:
Avoiding EHR Performance Issues in the First Place

Red Flag #1 – EHR Demo Slowness – Bring a red pen to your demo and every time they say something like, “It’s not usually this slow?” or “It must be slow because it’s running on my laptop.” make a BIG RED mark on your paper (or tablet if you’re advanced like that). Even one red mark should be cause for concern and investigation.

Certainly there are situations where environmental issues can cause slowness to an EHR. So, you can’t completely rule them out completely for this, but this is their demo. This is there one time to shine. If they can’t get their EHR demo running at full speed, what makes you think an EHR production environment will be much better?

You can make an extra red mark if it’s a SaaS EHR that’s providing the demo. They might say it’s just “the internet connection.” Well, guess what? Soon, that’s going to be you using that EHR and often on similar internet connections.

Of course, the message to EHR vendors is to make sure your demo runs as fast as your production system.

Red Flag #2 – Site Visit Slowness – While the demo can tell you a lot about an EHR software, it can’t necessarily tell you the speed of the EHR software. Just because the EHR is fast during the EHR demo, doesn’t mean that same EHR software will be fast in a production environment. Add this to the multitude of reasons why a site visit to a current user of that EHR is so important.

Make sure to do that site visit at one comparable in size and users to your clinic. You don’t want to look at the EHR responsiveness of a solo practice if you’re going to be a 6 provider multi clinic setup. Size matters when it comes to EHR speed.

Once on site, you can get an idea of the speed and responsiveness of the EHR software in two ways. First, observe the users of the EHR in the clinic. See if they exhibit any of the systems listed in the first section of this post. Another observation is to see how quickly they’re clicking around the EHR. If you see a lot of clicks in a row with little waiting in between clicks, that’s a great thing. If you see them click, wait, click, wait, click, click , wait. Be afraid.

The second way is to ask the EHR users. The problem with doing this is that only one response has value. If they say the EHR is slow, then you’ve gleaned some important information that’s worth checking on. If they say the EHR is fast, then you don’t necessarily know. The problem is that you don’t know what the user considers fast. What’s their frame of reference for saying it’s fast? Do they know what fast is? Have they just been using the EHR software so long that they’ve hit a rhythm that makes it feel faster than it really is? It’s a good sign if they say that it’s fast, but take it with a grain of salt.

Red Flag #3 – Use A Demo EHR System Yourself – Most EHR vendors will provide you a way to demo the product yourself. This isn’t a fool proof method to test EHR slowness, but it’s another decent test of the EHR’s responsiveness. Try it out using your internet connection and your computer hardware. Nothing like first hand experience documenting some patient visits to learn about the speed of an EHR.

EHR Speed Suggestion – Don’t Skimp on Hardware
Far too often I see a clinic skimp on the hardware requirements and regret it later. In fact, they often end up spending the money twice since they have to buy new hardware since they skimped in the beginning.

Of course, this suggestion can be taken too far as well. The computer and laptop manufacturers will try to sell you the whole kitchen and you might only need the stove and refrigerator. To put it in more practical terms, you’re going to want plenty of RAM, but do you really need the webcam, Blu-ray player, and special 100 in 1 media device?

Just because an EHR vendor says their EHR software can work on a certain hardware configuration doesn’t mean it should be used on that hardware configuration. In the middle there’s a spot between can and overkill that’s called optimal. Find that hardware configuration and you’ll be a much happier EHR user.

Conclusion
Don’t accept an EHR that’s slow. Make sure that the EHR performs at a satisfactory level. I know of nothing that frustrates a clinic more than a slow EHR.

Full Article here…

Related Articles:
“Our EMR is So Slow”

For Eligible Professionals there are two CMS programs, Medicare and Medicaid, which incentivize EHR use. An EP must select one of the programs for participation, and is allowed to switch programs once. Let’s take a look at Medicaid first. 2016 is the “Last year to initiate participation in the Medicaid EHR Incentive Program” and 2021 is the “Last year to receive Medicaid EHR Incentive Payment.”

Now, let’s take a look at the CMS matrix on page 4 of this document: From the matrix it is clear that a Medicaid EP whose first year in the program is 2016 has the potential to receive receiving the maximum incentive of $63,750. The same as an EP who entered the program in 2011.

For Medicare EPs it is a little more complicated as the incentives are front end loaded. Looking at page 5 on the CMS matrix located on the CMS website we can see that a Medicare EP can get the maximum incentives by beginning participation in either 2011 or 2012. To ease the path for the first year for Medicare EPs CMS states: “The reporting period for the first year is any 90 continuous days during the calendar year.” It doesn’t matter what year the Medicare EP begins, they only have to hit 90 days their first year. So to get the maximum Medicare incentive the EP must begin 2011 or 2012 with a 90 day period of the demonstration of meaningful use of certified EHR technology.

To bring it all to the bottom line here it is, short and sweet. For Medicaid EP the deadline for maximum incentives is 2016, and they only have to have signed a contract for a certified EHR that first year. For Medicare EPs the deadline is 90 days in 2012 which my calendar shows as October 3rd 2012.

Full Article here…

According to meaningful use experts, many radiologists mistakenly believe they were “left out” of the meaningful use rewards or that compliance is technically impractical.

However, “with diligent preparation, including the adoption of new technology and workflows, the vast majority of radiologists can qualify before October 2012 to capture the full available rewards and avoid later penalties,” said Murray A. Reicher, MD, chairman of DR Systems, Inc. and co-author of the article, which appears in the September issue of the Journal of the American College of Radiology.

Reicher recommends radiologists first become knowledgeable with regard to the required technology and clinical objectives. He also says it would be wise for radiologists to become active participants in their hospital information systems planning process.

“The regulations do not make it easy for radiologists and other specialists to qualify, but they will need to comply nevertheless, using existing and potentially emerging technologies, said Reicher.

“Ultimately, the requirement to collect and communicate clinical information in a standardized manner may finally provide radiologists the clinical integration required to provide ideal patient care,” he said.

Full Article here…

As more employees work remotely and use mobile phones for work, the risks are growing and security is getting harder to implement. Those are some of the conclusions of Symantec’s 2011 State of Security Survey, where Symantec surveyed more than 3,300 companies about the security threats they face. There’s no surprise in the report, but it reinforces the notion that companies need to pay more attention to cyber threats.

“Cyber security is once again top of mind for a lot of CEOs,” said Ashish Mohindroo, senior director of product marketing at Symantec, said in an interview. “It has always been a top-three concern for operations executives and chief information officers. But the awareness is high because of all of these breaches. The companies feel more vulnerable than in the past.”

About 71 percent of the companies surveyed reported that they have been attacked in the last year. About 21 percent saw the frequency of attacks increasing and 25 percent saw the attacks as somewhat to significantly effective.

Some 92 percent of those attacked saw losses including downtime, intellectual property theft, and customer credit card info loss. About 84 percent of attacks led to actual costs. About 20 percent of the businesses said they had lost at least $195,000 as a result of attacks.

“That’s a big disruption to the business and it takes a long time to recover from reputation loss,” Mohindroo said

As noted in a recent McAfee report, high-profile “hacktivist” groups such as Anonymous and LulzSec have changed the landscape by drawing a fine line between attacks for personal gain and attacks meant to send a message. There were roughly 20 major hacktivist attacks in the second quarter alone, mostly due to the alleged activity of LulzSec.

Companies said they are getting better at fighting the war on cyberattackers. Many suffered damages in cyberattacks, but more respondents reported a decline in the number and frequence of attacks compared to 2010. Spam has been reduced, thanks to the take-downs of some big bot nets such as Rustock.

Half of the respondents said they could still do more to secure their networks and assets. So they are increasing their cybersecurity staffing and budgets. About 46 percent are increasing security staffing and 38 percent are increasing security system budgets.

Mohindroo said that some of the drivers of the attacks are new, such as social networking as a vector for finding vulnerabilities. More attacks are personally targeting individuals as well. For instance, hackers can get your name or email address and send a message with a malware payload to one of your trusted friends.

“If you tell your friends that you are going to a conference, the attackers would discover that and craft a message saying they saw you there,” Mohindroo said.

And incidents such as the Wikileaks episode should remind companies that employees are often the perpetrators of cyberattacks against company networks.

The majority of the companies interviewed had more than 5,000 employees, and 1,200 of the respondents were high-level employees. The survey was conducted from April to May.

Full Article here…

The revenue cycle system, which includes registration, HIM and billing/AR, will be the lynch pin to ICD-10 readiness. Having a solid vendor partner and a strong product is key to a successful transition. Many solution providers – like gloStream,  – are updating their systems to with ICD-10. Strong vendor partners take the burden off you by being ahead of the game and delivering the appropriate technology in time so you are not racing to the finish line. gloStream plans to release their ICD-10 compliant version, 6040 in Sept of 2011, providing ample time to make the transition.

By now, you should have at least a steering committee in place. Your IT shop should have completed an inventory of all applications that are impacted by ICD-10, including reporting systems. You will be surprised by the number of applications, even if you have taken the one-vendor approach for most of your IT needs. You will need to contact all affected application vendors to see what the plans are for ICD-10 compliance. Most likely, upgrades will be required that will need to be scheduled.

Training of coders will be critical, along with implementing clinical documentation improvement programs. Documentation improvement programs are difficult to implement and will be viewed by providers as more work on top of an already busy schedule. New technologies such as computer-assisted coding will definitely help, but success will be a combination of process improvements and technology.

Lastly, remember that the deadline is for Medicare and Medicaid patients only. Unless the rest of the payer industry follows the same deadline (highly unlikely), you will need to run both ICD-9 and ICD-10 systems.

Full Article here…

gloStream, maker of gloEMR, gloPM and gloSuite – the only electronic medical record (EMR) and practice management software with Microsoft Office built right in – announced that its doctor clients have begun receiving federal EHR incentive payments from the Centers for Medicare and Medicaid Services (CMS).

The Medicare and Medicaid Electronic Health Records Incentive Programs were established as part of the American Recovery & Reinvestment Act. Under the programs, eligible Medicare and Medicaid providers can receive up to $44,000 and $64,000, respectively, if they attest to Meaningful Use of a certified EMR or EHR solution. Meaningful Use measures have been defined by CMS and include, amongst others: using an EMR to send prescriptions electronically, recording smoking status, providing patients with educational materials, maintaining active medication lists, and recording patient demographic information.

“gloEMR from gloStream is so flexible that the software could easily adapt to the changing workflows we put into place to comply with Meaningful Use criteria,” said Dr. Steven Bauer an Internist in San Antonio, Texas. “We also found gloStream’s Meaningful Use dashboard to be a tremendously valuable resource. Thanks to this tool the CMS attestation process was easy and we received our Stimulus incentive funding quickly.”

The Office of the National Coordinator for Health Information Technology has released data showing that 41 percent of all office-based physicians intend to take advantage of federal EHR incentive payments. In addition, according to a survey from the Medical Group Management Association, 80 percent of medical practices that have already adopted an EHR say they intend to participate in the federal EHR incentive program.

“After several years of scrutinizing the industry’s best EMR options for our growing practice, we were introduced us the gloStream software system,” said Dr. Scott Adelman, an expert in spine care and sports medicine and founder of The SMART Clinic, in Sandy, Utah. “The federal EHR incentive program motivated our practice to choose a system committed to meeting the tracking requirements for achieving Meaningful Use criteria, and gloStream presented the exact opportunity we had been searching for all along. With gloStream’s solutions and their partner’s outstanding support, we successfully converted our nearly 20-year practice to a completely electronic medical office. And, we’ve already received our first Stimulus incentive check after they walked us through the entire CMS attestation process.”

“We’ve worked very hard to give our practice clients the tools and resources they need to successfully acquire federal EHR incentive funding,” said Brenda Hodge, Executive Vice President of Partners and Practices at gloStream. “It’s extremely gratifying when our clients report back to us that we’ve helped make a challenging process simple and easy.”

About gloStream

gloStream provides doctors with certified, voice-enabled electronic medical record and practice management solutions delivered and supported through a nationwide community of local technology partners, like iTelework.  gloStream products are secure, easy-to-use applications and the only solutions on the market with Microsoft Office built right-in. gloStream partners leverage gloDNA (“gloStream Detailed Needs Analysis”), an innovative implementation process that is key to its 100% implementation success.

For more information, contact iTelework:  www.iTelework.com,  info@iTelework.com or 1-888-673-6683.

Sage Healthcare Division, a developer of electronic health records for medical practices across North America, worked with Forester to conduct a survey among physicians nationwide in an effort to examine perceptions and determine attitudes toward these systems. The sample included both physicians using EHR and those in the market for the technology.

The purpose of this study was to gain a better understanding of potential cost savings, benefits of these systems to small and mid-sized practices and to find any intangibles of using EHRs, such as physicians providing care from multiple locations or helping physicians have more time away from the office because of increased mobility and connectivity.

“Implementation of EHRs in the U.S. continue to grow as an increased number of physicians and staff gain a better understanding of  the efficiency and cost-saving benefits of using the technology,” said Betty Otter-Nickerson, president of the Sage Healthcare Division. “However, a significant number of office-based practices have yet to implement an EHR solution. Sage’s survey was conducted to examine current perceptions and predominant trends that will help us design the best solutions to maximize the benefits of EHR.”

The survey findings indicated that meaningful use incentives are still one of the strongest drivers for most physicians (64 percent) to implement EHR technology, but for 32 percent of those who are in the market for EHRs, insufficient capital is still a key challenge to the switch.

The survey found that EHR users said they measure their success through reporting and tracking healthcare outcomes (64 percent) and error reduction (62 percent), but those who have yet to purchase EHR responded they would measure EHR success through increased revenue (74 percent) followed by reporting and tracking healthcare outcomes (60 percent).

Also, current EHR users are more aware of additional benefits than those who haven’t implemented the technology yet and expected achievements with EHR are stronger for those who have already purchased the solution.

Key findings of the survey in general:

• 77 percent saw ease of use and quickness as a top characteristic in an EHR solution
• 39 percent of respondents ranked improved and timely access to accurate patient information as the most important reason to achieve their EHR goals, followed by reduced time spent in information search and management (34 percent)
• Physicians who have already implemented EHRs perceive more value in lower costs and improved staff efficiency than those in the market for an EHR solution (35 percent versus 25 percent)
• When surveyed physicians were asked about SaaS as an alternative to an in-office solution, both those with or without EHR (39 percent) had security and data privacy concerns about the outsourced solution

For EHR users:

• Physicians who have already implemented EHR largely reached their business goals of lower costs and improved patient service (80 percent) and improved staff efficiency (74 percent)
• 72 percent of those surveyed saw the increased availability of floor space that was previously occupied by paper records as a major advantage of EHR, second only to reduced administrative costs (82 percent)
• 56 percent see error reduction as the number one tangible benefit of EHR, followed by ability to share patient information (38 percent)
• 68 percent have seen mobile access to information as the biggest intangible benefit of EHR (34 percent)
• Of all the EHR users surveyed, 52 percent said that reduced paper and office expenses saved them the most money
• 76 percent of respondents said they would invest in EHR again
  

For non-EHR Users:

• Of all non-EHR users, 30 percent would prefer having in-office EHR to an outsourced solution, such as SaaS or off-client software

“Some of our EHR customers have indicated they are spending more time away from the clinic because of the system’s efficiency and accessibility off-site,” said Otter-Nickerson. “This accessibility also saves them time during each patient visit, which translates into more quality time spent with the patient. Another great advantage of EHR is that doctors can look up a patient’s entire history and have a comprehensive view of their health. Consequently, doctors can make more informed decisions, thus improving the quality of care and potentially generating better health outcomes.”

Original Article here…

To date, about 77,000 providers have registered for the program aimed at promoting the adoption and use of electronic health records.

CMS has collected data about healthcare providers that have attested that meet Stage 1 meaningful use, offering a glimpse of the experience of early adopters of certified electronic health records. One of the findings showed that providers used required EHR functions with a higher percentage of patients than was called for in the requirements, according to CMS officials.

Twenty-one states have launched their Medicaid EHR program, with Arizona, Connecticut, Rhode Island and West Virginia in the past month, according to CMS.

Among preliminary data, 2,383 physicians and other eligible professionals had verified that they met meaningful use requirements under the Medicare program, with 137 attesting unsuccessfully. The analysis did not explain why those providers failed attestation, but the agency will drill down to find the reason behind the numbers, said Robert Tagalicod, the new director of CMS’ Office of e-Health Standards and Services. However, 100 hospitals have attested and all have done so successfully.

The agency is cautious about what the numbers may indicate and is aware that early adopters may have more experience with EHRs than later adopters, Tagalicod told the Health IT Policy Committee, which advises the Office of the National Coordinator (ONC).

“It would be too early to draw conclusions yet, but we will be working closely with the policy committee as well as ONC to understand what these data say to us and how we should interpret them so we can translate them into something more programmatic,” he said.

CMS has paid Medicaid incentives to 3,500 physicians and hospitals for adoption, implementation and upgrades of certified EHR technology, and under the Medicare program, 1,000 physicians and hospitals.

Farzad Mostashari, MD, the national health IT coordinator said that from what he has heard from the field, there is “an incredible amount of movement happening. The changes that are happening may be difficult to see day to day. But from where we are today from where we were two years ago, the transformation is real and it’s happening.”

One particular statistic in CMS’ data is promising. The number of physicians who received meaningful use incentive payments under Medicare increased significantly in July over June, from 329 physicians to 566, said Elizabeth Holland, CMS’ director of health IT initiatives group. “We’re hoping that that will be a continuing trend,” she said.

To receive payments of up to $18,000 in 2011, providers must not only attest that they can demonstrate meaningful use but meet the threshold of $24,000 for allowed charges in claims for covered services to Medicare beneficiaries during 2011.

Also in the July report, CMS included for the first time the medical specialties associated with the eligible physicians and other professionals. The two top specialties are family practice and internal medicine.

Among other findings, providers on average met or exceeded the threshold performance or percentage of a provider’s patients involved in a measure demonstrating an EHR’s functionality, Tagalicod said. For example, providers had to use computerized physician order entry (CPOE) for at least one medication order entered for more than 30 percent of unique patients who have at least one medication on their medication list. On average, providers used it for 87 percent of the defined patient population, he said.

Neil Calman, MD, a policy committee member and CEO of the Institute for Family Health in New York, said the findings supported what many have believed about advanced functionality.

“Once you have the capability of doing something in your system, people tend to do it much more than the thresholds we’ve set. So once you start doing e-prescribing, you can do it for everybody. I wouldn’t be surprised if these high levels are maintained as people qualify,” he said.
The most popular menu or choice objectives for attesting providers were to incorporate lab results, conduct drug formulary checks and fulfill patient lists. The least popular were conducting medication reconciliation and summary of care record at transitions.

Original Article here…