EMR & EHR Blog for Physicians

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This time I decided to write this post about a slightly different topic - Coding Compliance. As we discuss below, when physicians implement EMR or EHR, the need for a good compliance plan will not disappear contrary to what some physicians may believe.

While most physicians would like to avoid an coding audit, it is a fact of life in today's healthcare world. To lessen the stress and potential penalties, preventive maintenance is the key. Regular internal and external audits should be part of every compliance plan.

The OIG (Office of the Inspector General) states: "The best evidence that a provider's compliance program is operating effectively occurs when the provider, through its compliance program, identifies problematic conduct, takes appropriate steps to remedy the conduct and prevent it from recurring, and makes a full and timely disclosure of the misconduct to appropriate authorities." To identify problem areas, utilization of internal and external audits is key.

As most EHR Vendors proclaim, Electronic Health Records help physicians maximize billing in the following two ways:

1. When using paper charts, to be on the safe side of the law, many physicians down code (use a lower billing code), rather than use an appropriate level of code. Providers who use EHR software can increase revenues by using System recommended E&M billing codes that are based on the service accurately documented within the EHR, without the fear of an audit, or if an audit occurs, being confident that their coding is compliant with their documentation. Medical Economics magazine has estimated that physicians, who routinely down-code to avoid audits, lose an average of $40,000 annually.
2. EHR software allows physicians to produce adequate supporting documentation that complies with CMS guidelines and supports the appropriate level of service to be billed. Accurate coding speeds up the reimbursement process and results in fewer rejected claims from insurance companies. Even better, an EHR Software helps produce clean claims the first time, significantly reducing the number of rejected claims!

The question that often arises when we talk to Physicians is: We are investing money in an EMR or EHR. Do we still need to have a Coding Audit or Coding Compliance program? The answer is "YES".

February 2010 edition of American Academy of Professional Coders' (AAPC) Coding Edge magazine states, "The goal of the EMR is to improve the efficiency of the physician in documenting services and ensuring all work performed is capture in the record." While EMRs can help with speeding up reimbursement, they will not prevent a physician from receiving denials. EMRs can improve coding and documentation, but physicians need to take the time to document services in order to meet medical necessity standards.

Physicians sometimes fail to realize that coding is more than just code selection and needs to consider items like Commercial payer rules, local coverage determinations, mitigating circumstances, government health programs and numerous other variables introduce rules, exceptions to the rules, and more. How many EHR Solutions can automate all the aforementioned complex rules which are forever in a state of flux and keep changing frequently? My guess is that by pareto's principle, EHRs can probably code 80% of the encounters accurately while balance 20% of the encounters need to be reviewed and/or coded appropriately by experienced coders. An example of this would be modifier selection and proper use of modifiers. These would need to be manually entered by either the physician or a certified coder.

Our experience reveals that when a Practice implements an EHR, the extent of coding audit required may decrease but nevertheless every Practice still needs to implement coding audits. You can choose to conduct the audits internally or use external auditors. Internal audits are a valuable tool, but are limited by the auditor's knowledge and expertise. Internal auditors may already be overwhelmed by their daily duties of running an office. They may not have the time between scheduling patients, ordering supplies, etc...to conduct a thorough audit. Regulations change constantly, which means a designated employee must be assigned to read publications, attend seminars and share this information with physicians and coders in their practice. Auditors should be certified and competent. An auditor is not just a Certified Coder. It takes many years of experience and education to be a thorough auditor. It is a separate skill from coding.

For these reasons, an annual external audit is invaluable for objectively analyzing billing and coding operations. It can uncover documentation deficiencies that an internal auditor may overlook and identify missed revenue in the process. Professional billing companies with dedicated teams of auditors can provide this service in a cost effective manner.

It takes physicians years of education to successfully practice medicine and even more to specialize in one area, plus stay abreast of changes and advancements in medicine. With the billing and coding requirements of today, it takes a specialist in that field to provide the same level of expertise. External auditors will also take the time to provide one-on-one feedback to individual physicians utilizing their own charts as examples and can pinpoint precise documentation deficiencies.

In closing, while implementing an EHR is a giant step in automating clinical processes, a good compliance plan that utilizes internal and external auditors shows your offices' desire to operate within the guidelines is equally important. If discrepancies are found, penalties will be less severe because you are showing due diligence to be in compliance.

(Parts of this blog post have been contributed by Kathy Husted, CPC, CPC-H, CPC-I, who works for Professional Billing & Management Services, an Affiliate of RevenueXL Inc.)

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

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The world of healthcare is changing especially so in the light of an estimated 30 million new patients that will be added to the healthcare system. Most of them will be tended to by Family Doctors (including internists and pediatricians). Primary care practices typically measure productivity according to the number of visits, which also drives payment (which is less than half the money earned by specialists).

Besides the low salaries, there is tons of work that does not involve a visit from a patient, is invisible to those who support and purchase primary care and is therefore uncompensated.

In a recent study documented, each internist handled 18 visits per day in addition to the following unpaid tasks:

• 24 telephone calls (80% handled directly by Physicians; 28% resulted in writing of prescription and 8% ended in ordering of new tests)
• 12 prescription refills processed
• 20 laboratory reports read - they frequently trigger a review or adjustment of a medication, which requires access to accurate, current medication lists with doses.
• 14 consultation reports from specialists examined
• 11 X-ray and other imaging reports reviewed which may require updating problem lists or further referrals
• 17 e-mail messages including interpreting test results (59%) or responding to patients (22%)

The above numbers reveal phenomenal quantum of uncompensated work that is performed by primary care providers. If the metrics used for compensating these providers is not changed quickly, then it is easy to predict that the shortage of family doctors will increase at a rapid pace and the complete primary healthcare ecosystem will start crumbling.

The same study also dealt with implementation of Electronic Health Records and the changes in practice design that this brought forth in a Primary Care setting. Primary Care Physicians play a number of roles in the course of discharging their daily duties - from making diagnoses and providing treatment to ordering tests and filling out forms. How and by whom the work is done is dependent on both the skills of available support (non-physician) staff and the extent of information-technology support.

When EHR Software is implemented in a Primary Care Clinic, roles played by Clinic personnel often change. In this documented case study, the following changes were recorded:

1. The job profile of the registered nurse changed significantly after implementation of Electronic Health Records. While the nurse's work could be handled by personnel without any nursing skills, new duties of the nurse included doing "information triage" of incoming laboratory reports, telephone calls, and consultation notes.
2. Additional front-desk staff and medical assistants were hired to handle the increased tasks associated with the comprehensive management of chronic diseases like diabetes, etc.
3. Productivity metrics of the Physicians were changed from just using total charges (or number of visits) to including telephone calls and e-mails handled.
4. Doctors now rely on availability of comprehensive, contemporaneous structured data when responding to telephonic calls and lab results.
   
5. The purpose of documentation has shifted from billing to ongoing clinical care, and the EHR is now used more for 'information management' and 'active support of clinical-practice activities' (rather than mere progress note generation).

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

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To give you some perspective of what this means, here are some numbers from the report to ponder about:

Claims:

Presently 75% electronic utilization
Provider cost savings electronic vs. paper: $3.73
Payer cost savings electronic vs. paper: $0.73

Eligibility:

Presently 40% electronic utilization
Provider cost savings electronic vs. paper: $2.95
Payer cost savings electronic vs. paper: $1.38

Claim Status:

Presently 40% electronic utilization
Provider cost savings electronic vs. paper: $3.33
Payer cost savings electronic vs. paper: $2.56

Claim Payment:

Presently 10% electronic utilization
Cumulative Provider and Payer cost savings electronic vs. paper: $4.80

Claim Remittance:

Presently 26% electronic utilization
Provider cost savings electronic vs. paper: $1.49

TOTAL:

Total unrealized industry savings: $29,718,502,500
Present transaction types by percentage: 57% paper / 43% electronic

This begs the questions: aren't billing and payment transactions already electronic? Didn't HIPAA simplify administrative aspects of healthcare years ago? If so, what really happenned?

According to the report, these are common misperceptions about the business side of healthcare. The facts are quite different indeed. While Health Insurance Portability and Accountability Act of 1996 (HIPAA) addressed administrative simplification, and it was hoped that this would provide the mandated framework necessary to unify the system in transition to automation, it did not provide any detailed operating rules, leading to significant operational variances from payer to payer. It not only resulted in inconsistent formats but has also mades it almost impossible to create interoperable and fully electronic systems.

The Administrative Simplification provisions of the healthcare reform legislation are designed to accelerate the standardization of transactions and solidifying a set of operating rules that will eliminate these kinds of inconsistencies.

Healthcare industry can accrue these benefits irrespective of whether or not the perceived benefits of EHRs are realized. As we have seen the meaningful use of EHR definition and certification process has ben dogged by political controversies and / or clinical concerns. I have no doubt in mind that they will get resolved in the mid to longer term timeframe, but surely they will not get resolved in the short term.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

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Is the EMR software you recommend CCHIT Certified?  This is one of the most common questions physicians ask me during a first EMR Software Consultation.  My answer is, “of course” that is, until HHS recognizes another organization accredited to certify EMR Software. So while being CCHIT Certified is a good requirement to strongly consider in your search for a good EMR, it should not be used as the all encompassing endorser of every EMR Vendor you come across in making your final decision.  So what else can one do to go beyond the certification process?  Well, you can take it to the streets, so to speak.  That is, where do you go to find out how well an EMR software you may be considering is working or what are the most common criteria being used to grade EMRs in the real world of Medical Practice?

There are several well recognized grading or ranking organizations that compare EMR features and functions, survey and interview end users, and conduct performance tests of EMR Software. These results can be used by physicians as a practical “Report Card” to assist them in evaluating EMR Software and EMR Vendors.

Essentially, physicians in Ambulatory Practices of all sizes can use this information as an additional screening tool to further narrow down their selection list to include EMR Software that has earned excellent scores for their unified Electronic Medical Records (EMR) and practice management (PM) solutions as it pertains to their individual requirements.  

Here are a few of the well recognized EMR Software rating or ranking resources and examples of the information they can provide:

IDC Health Industry Insights

This IDC Health Insights report discusses ambulatory EMR functionality for small and midsize practices with 20 providers or less and presents an assessment of the offerings of 10 vendors that serve this space. This report considers the requirements and cost relief provided by stimulus payments under ARRA, alongside additional assessment criteria that consider results from EMR including the migration from paper charts to electronic documentation, electronic ordering, charge capture, and improvements to patient safety and the quality of care.

TEPR

TEPR Awards identify outstanding health information technology and electronic medical record (EMR) innovations and solutions.  Physicians can use this information to identify EMR Software that has received the highest scores available in important areas including pricing, implementation cost, features and functions, references, support and maintainence, and overall customer satisfaction.

The TEPR Documentation Challenge is one that you may hear many vendors touting about and that ranks their EMR Software for their charting abilities and speed compared to manual charting.

 KLAS

You have probably heard this phrase used a lot: "Best in KLAS" Awards. This is an annual competition amongst EMR Vendors to determine the “Top 20 Best in KLAS” awards report.

KLAS helps healthcare providers make informed technology decisions by offering accurate, honest, and impartial vendor performance information. KLAS independently monitors vendor performance through the active participation of thousands of healthcare organizations. KLAS uses a stringent methodology to ensure all data and ratings are accurate, honest and impartial. Research results are offered to healthcare providers through:

• A free directory of vendor and product information

• Free online access to vendor ratings for participating providers

• On-depth published reports, discounted for participating providers

AN IMPORTANT CAVEAT to mention here, is that not all EMR Software on the market are evaluated and therefore, even this information should not be wholly relied upon as the "super-list " of EMR Software options available to you. There are many EMR Vendors that have not been evaluated by one of these organizations, but if they were to be put to their tests,  they would rank high and pass with flying colors.  So, if you are considering an EMR Software that may not be on the “A” list of one or more of these reports, the more important take-away from these evaluating organizations is to make good note of the major  categories and criteria that are being assessed and make them a part of your evaluation process when comparing EMR Software and interviewing EMR Vendors. 

Also worth mentioning, in a majority of cases, EMR Vendors actually pay to have their EMR Software included in thsee independent assessments.  Now you can make your own conclusions here but, that does not necessarily mean there is anything under-handed going on. 

So, to the extent that an EMR Vendor is being evaluated by one of these reputable organizations, use this information more as another good reference resource throughout your EMR screening and selection process.

My best advice, find a good EMR Consulting company to help guide you in the right direction for finding and comparing EMR Software.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

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I cam across an interesting article on a very important topic that is very relevant in the light of recent discussion and legislation on 'meaningful use' of Electronic Medical Records (aka Electronic Health Records).

It was a survey that involved sixty respondents, including 52 physicians or staff from 26 practices with commercial ambulatory care EMRs in place for at least 2 years, chief medical officers at four EMR vendors, and four national thought leaders. There were 6 major findings:

1. EMRs facilitate within-office care coordination, chiefly by providing access to data during patient encounters and through electronic messaging;
2. EMRs are less able to support coordination between clinicians and settings, in part due to their design and a lack of standardization of key data elements required for information exchange;
3. Managing information overflow from EMRs is a challenge for clinicians;
4. Clinicians believe current EMRs cannot adequately capture the medical decision-making process and future care plans to support coordination;
5. Realizing EMRs' potential for facilitating coordination requires evolution of practice operational processes;
6. Current fee-for-service reimbursement encourages EMR use for documentation of billable events (office visits, procedures) and not of care coordination (which is not a billable activity).

The third goal of 'meaningful use' focuses on improving care coordination by enabling exchange of meaningful clinical information among professional health care team by requiring the EHR to possess the following capabilities and functions:

1. Capability to exchange key clinical information (for example, problem list, medication list, allergies, and diagnostic test results), among providers of care and patient authorized entities electronically.
2. Perform medication reconciliation at relevant encounters and each transition of care.
3. Provide summary care record for each transition of care or referral.

Given the survey findings listed in the earlier part of this blog, I am personally skeptical how many of the current versions of EHR Software solutions can pass the three capability tests (as above). The jury is out and we will better know which EMR / EHR Solutions will effectively meet the goal as far as co-ordination of care is concerned in the next few months.

If any EMR / EHR vendors or current users of EMR / EHR solutions would like to share their understanding, knowledge or perspective on this topic, please feel free to leave a comment.

We will continue exploring different aspects of 'meaningful use' over the next several weeks.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

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Now that the HHS has issued two sets of long-awaited and much-anticipated federal regulations on list of "meaningful use" criteria that healthcare providers must meet to qualify for federal IT subsidies and the standards and certification criteria that those EHRs must meet for their users to receive the EMR incentives, one is left wondering what is the real value of CCHIT certification and do those EMR vendors who went in for CCHIT certification and spent over $40000 each for the certification without waiting for the meaningful use get any headstart?

Here is a summary of an article that was published by Modern Healthcare today:

CCHIT may have had close ties to HHS in the past but that is history. David Blumenthal, the current head of the ONC, in a meeting was responding to a question about existing CCHIT certifications of Electronic Health Records and HHS' prior recognition of CCHIT as a certifying body.

Blumenthal mentioned that to qualify to receive incentive payments, the EHR would have to be certified by a body certified by the Office of the National Coordinator and that ONC is working towards creating a process to recognize that body.
Blumenthal mentioned that even though CCHIT was recognized in the past as a certifying body, its future status will be governed by the regulatory process that is ongoing right now. He termed as premature the talk about the implications of any particular set of certification criteria that CCHIT or anybody else has put forward or will put forward.

Mark Segal, Vice Chairman of the Electronic Health Record Association of HIMSS said the stimulus law, gives the ONC the authority to go ahead and retroactively accept any EHR systems certified under the old CCHIT process as certified under the new stimulus law provisions.

The ONC rule-makers explained the rationale behind this decision to scrap the previously accepted certification criteria and process. HHS, they wrote, decided not to accept CCHIT certification criteria due to "our approach of aligning adopted certification criteria with the proposed definition of meaningful use."

Segal said there still are "a reasonable expectation that CCHIT will be one of those" organizations that will again be recognized by the ONC. He also mentioned that CCHIT certification criteria come quite close to matching those new criteria being developed by the ONC. As a result, if an EHR is already certified up until now means it already has a lot of the functionality in place.

I do believe that the EMR Vendors who spent the time and financial resources in advance of the recent formal release of regulations, they are at an advantage as compared to a large number of vendors who do not have any certification, whatsoever. A number of smaller EMR vendors got certified in 2006, but as the competition is heating up, are already on the way to getting their EHR certified under the CCHIT 2011 Certification Program.

As I have earlier mentioned in another blog of mine, just because a Physician implements a Certified EMR does not mean that it is used in a meaningful manner, one of the EHR selection criteria must therefore include the ease with which the EHR allows demonstration of meaningful use to CMS.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

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1. List of "meaningful use" criteria that healthcare providers must meet to qualify for federal IT subsidies based on how they use their electronic health records. 
2. The standards and certification criteria that those EHRs must meet for their users to collect the money.

Phased Approach to Meaningful Use

What has been proposed is a phased approach that encompasses reasonable criteria for meaningful use based on currently available technology capabilities and provider practice experience, and builds up to a more robust definition of meaningful use, based on anticipated technology and capabilities development.

Under this phased approach to meaningful use, the criteria of meaningful use would get updated through future rulemaking. The initial meaningful use criteria have been referred to as "Stage 1."

(Stage 2 criteria are expected to be proposed by the end of 2011 and the Stage 3 definition may be proposed by the end of 2013.)

Stage 1 Meaningful Use Criteria

The Stage 1 meaningful use criteria focuses on electronically capturing health information in a coded format; using that information to track key clinical conditions and communicating that information for care coordination purposes (whether that information is structured or unstructured, but in structured format whenever feasible); consistent with other provisions of Medicare and Medicaid law, implementing clinical decision support tools to facilitate disease and medication management; and reporting clinical quality measures and public health information.

Stage 2 and Stage 3 Meaningful Use Criteria

Stage 2 meaningful use criteria shall expand upon the Stage 1 criteria to encourage the use of health IT for continuous quality improvement at the point of care and the exchange of information in the most structured format possible, such as the electronic transmission of orders entered using computerized provider order entry (CPOE) and the electronic transmission of diagnostic test results (such as blood tests, microbiology, urinalysis, pathology tests, radiology, cardiac imaging, nuclear medicine tests, pulmonary function tests and other such data needed to diagnose and treat disease).

Stage 3 meaningful use criteria shall focus on promoting improvements in quality, safety and efficiency, focusing on decision support for national high priority conditions, patient access to self management tools, access to comprehensive patient data and improving population health.

Stage 1 Meaningful Use Defined in Detail

Goal 1: To further the care goal of improving quality, safety, efficiency and reducing health disparities.

1. Use CPOE (which entails the provider's use of computer assistance to directly enter medical orders (for example, medications, consultations with other providers, laboratory services, imaging studies, and other auxiliary services) from a computer or mobile device. The order is also documented or captured in a digital, structured, and computable format for use in improving safety and organization. For Stage 1 criteria, it will not include the electronic transmittal of that order to the pharmacy, laboratory, or diagnostic imaging center)
2. Implement drug-drug, drug-allergy, drug-formulary checks.
3. Maintain an up-to-date problem list of current and active diagnoses based on ICD-9-CM or SNOMED CT®. It also includes past diagnoses relevant to the current care of the patient.
4. Generate and transmit permissible prescriptions electronically (eRx).
5. Maintain active medication list.
6. Maintain active medication allergy list.
7. Record the following demographics: preferred language, insurance type, gender, race and ethnicity, and date of birth.
8. Record and chart changes in the following vital signs: height, weight and blood pressure and calculate and display body mass index (BMI) for ages 2 and over; plot and display growth charts for children 2 - 20 years, including BMI.
9. Record smoking status for patients 13 years old or older.
10. Incorporate clinical lab-test results into EHR as structured data.
11. Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, and outreach.
12. Report ambulatory quality measures to CMS (or, for EPs seeking the Medicaid incentive payment, the States).
13. Send reminders to patients per patient preference for preventive/follow-up care. Patient preference refers to the patient's choice of delivery method between internet based delivery or delivery not requiring internet access.
14. Implement five clinical decision support rules relevant to specialty or high clinical priority, including for diagnostic test ordering, along with the ability to track compliance with those rules.
15. Check insurance eligibility electronically from public and private payers.
16. 16. Submit claims electronically to public and private payers.

Goal 2: Provide patients and families with timely access to data, knowledge, and tools to make informed decisions and to manage their health

1. Provide patients with an electronic copy of their health information (including diagnostics test results, problem list, medication lists, allergies) upon request. Electronic copies may be provided through a number of secure electronic methods (for example, personal health record (PHR), patient portal, CD, USB drive).
2. Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, allergies) within 96 hours of the information being available to the EP. Electronic access may be provided by a number of secure electronic methods (for example, PHR, patient portal, CD, USB drive). Timely is defined as within 96 hours of the information being available to the EP either through the receipt of final lab results or a patient interaction that updates the EP's knowledge of the patient's health. 
3. Provide clinical summaries for patients for each office visit.

Goal 3: To improve care coordination by enabling exchange of meaningful clinical information among professional health care team.

1. Capability to exchange key clinical information (for example, problem list, medication list, allergies, and diagnostic test results), among providers of care and patient authorized entities electronically.
2. Perform medication reconciliation at relevant encounters and each transition of care.
3. Provide summary care record for each transition of care or referral.

Goal 4: To improve population and public health by having the patient's health care team communicate with public health agencies.

1. Capability to submit electronic data to immunization registries and actual submission where possible and accepted.
2. Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission according to applicable law and practice.

Goal 5: To ensure adequate privacy and security protections for confidential information through operating policies, procedures, and technologies and compliance with applicable law and provide transparency of data sharing to patient.

1. Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

If you like this post, please subscribe to our Email Subscription to read our new posts in your email.

________________________________________________

RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

If you like this post, please subscribe to our Email Subscription to read our new posts in your email.

The term "system" originates from the Greek term syst¯ema, which means to "place together" and defines a system as an integrated set of interoperable elements, each with explicitly specified and pre-defined capabilities, working seamlessly to perform value-added processing to enable a user to achieve set objectives.

An EMR System includes these basic components:

1. Infrastructure- Physical and hardware system components, for example, Workstations and Servers, Tablet PC, Laptops, Monitors, Scanners, Routers and Bridges, etc.
2. Software- Application software (EMR Software or EHR Software), Operating System software, utilities, and other applications like Instant Messaging, Fax Servers, Networking Software, Lab interfaces, ePrescription, etc..
3. People-Personnel involved in using, maintaining or managing the EMR - this includes the clinical and administrative staff, Physicians, etc . These personnel need to receive appropriate level of training.
4. Business Processes-Guidelines, instructions, and steps involved in keeping the EMR System running smoothly. This includes patient appointment scheduling, reminders, billing, etc.
5. Data-Information captured, used, and supported by a system, including documents, images and databases.

It is clearly evident that EMR software is just one component of an EMR System and is therefore a subset of EMR System. It is not good enough to assemble motley of ill-fitting components to create an EMR System since they may not work seamlessly and will certainly not perform value added processing.

So what are the implications from a Physician's perspective?

When Physicians buy EMR Software from EMR Vendors, they typically get the following:

1. EMR Software (application software)
2. Application Database
3. Configurable Lab and Pharmacy interfaces
4. Specifications of recommended commonly required and used hardware

To take the above and convert this to a fully functioning EMR System takes skills of different kinds - technical and functional. Also as you can see, unless you take the required steps to create an optimized System that performs value added processing, you shall not get the required Return on Investment (ROI).

Physicians are expert at providing quality healthcare to their patients but do not have the necessary expertise to assemble all the components to build and implement the EMR System. By working with an expert EMR Consulting company or an EMR Systems Integrator to build and integrate all required components of a customized EMR System, you can ensure successful implementation and reap maximum benefits from EMR Software deployment.

(Research Support provided by: Om)

RevenueXL can assist you in deriving maximum ROI from your investment in EMR technology by converting your EMR Software into a fully functioning EMR System. Contact us right away for a Free Consulting Session.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

If you like this post, please subscribe to our Email Subscription to read our new posts in your email.

Medicare payments to physicians not qualified as “meaningful users” of Certified Electronic Medical Record software will be reduced by 1% in 2015, then 2% in 2016, 3% in 2017, 4% in 2018, and by as much as 95% in subsequent years.

To avoid this situation your timing is critical. Experts predict that by mid-to-late 2010, the demand for Electronic Medical Record Systems may far exceed the number of qualified sales and support staff that companies with Certified Electronic Medical Record software will have to meet the last minute rush of physicians suddenly realizing their forthcoming financial misfortune. Therefore, now is the time to take action and give serious attention to the 2 to 4 months of lead-time required for planning and selection, set-up and training, implementation and “go live”. Then, add an additional 6 to 8 months to ensure physicians and staff are proficiently up and running as “meaningful EHR users”, so that each physician in your practice is eligible for the up to $44,000.00 in Medicare Incentive Payments beginning in January 2011.

Late adopters can surely expect huge delays or worse, being placed on a waiting list (at least by the best and most popular EMR software vendors).  In this case, your options may become very limited, and prices may even increase.  So, instead of receiving Bonus Payments, you may wind up being penalized through reduced payments.  Don’t be surprised if you find yourself on a “hotchpotch” path of trying to force-fit poorly matched EMR and Practice Management software together from different vendors. This predicament will cost you a lot of time, frustration, and money.

There are over 300 EMR vendors on the market, and only a few are CCHIT Certified and qualified take on the question, “Which EMR has the smoothest transition and implementation that meets the requirements of your practice and, ensures each physician in your practice receives the maximum Medicare Incentive payments?” The answer, find a good Independent Consultant who, at no cost to you, can help you find the best-fit Certified Electronic Medical Record software, which has all the answers “built-in”.   

It’s not everyday the government imposes new laws, regulations, costs, and penalties upon your business and then, turns around and pays you, to become compliant and avoid being penalized. Now is the time to start positioning each provider in your practice to leverage every Bonus Incentive dollar available. After all, the right-fit Electronic Medical Record software will make running your practice easier, more profitable, boost morale, improve patient care and, enhance your quality of life and that of your patients.  Everyone will “feel” the difference.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.