Top 10 EHR Topics in 2012

Happy New Year! It has been a busy year for our EHR and EMR Insights blog so we thought we’d share our top 10 most popular posts from 2012:

Take a look back and enjoy:

10. Strengthen Your Bottom Line: 7 Immediate EHR Benefits 

Would you like to strengthen the bottom line of your medical practice? With the right EHR, you can increase revenue, cut expenses, and enjoy the benefits of a well-organized and efficient office…read more

9. Is It Time? Assessing Your EHR Readiness 

Are you ready to take the EHR plunge? Take a moment to evaluate your current situation and status…read more

8. Data Exchange: Reaching beyond the Walls of Your Practice 

As we move towards greater demands for EHR interoperability, health information exchange (HIE) is an increasingly important means of sharing healthcare-related data…read more

7. Managing Meaningful Use: Customer Support Is Imperative 

Partnering with an EHR vendor who lives up to the promise of providing high-quality customer service assures that your practice will experience long-lasting success…read more

6. Delinquent EHRs and the Doctors Who Hate Them 

Unfortunately, there are still too many delinquent EHRs out there, and too many stories of practices faced with unexpected expenses, decreased patient satisfaction, nerve-wracking workflow disruptions, and sharp drops in the quality of life…read more

5. 5 Questions You Should Ask EHR Executives 

It’s important to ask questions during your EHR selection process, but it’s even more important to know which questions to ask…read more

4. Top 5 Changes in Patient Expectations 

As health care information technology (HCIT) advances, EHRs continue to be both a valuable asset for patients and a necessity for physicians…read more

3. Warning: Inside-EHR Info Nobody Told You 

As you search for an EHR, it’s common to be told exactly what you want to hear, but then be surprised later with unwelcomed results…read more

2. EHR Implementation: Don’t Let Fear Hold You Back 

If you are thinking about transitioning your practice from paper charts to an EHR, or even transitioning from your old EHR vendor to a new one, you’re most likely concerned about the implementation process and the long-term impact on your practice…read more

1. EHR Interoperability: Making Sense of It All 

In Stage 2 of meaningful use, interoperability takes center stage: there’s increased attention and focus on the sharing of data. It’s more important than ever to understand the differences among EHR vendors’ data…read more

Holiday Treat: The 12 EHR Recommendations

It’s that time of year again! We’re back with 12 holiday recommendations that are sure to keep on giving!

Whether your practice is looking to buy your first EHR or replace your current system, we hope these valuable insights help you through difficulties you might have.

Here are our 12 recommendations:

1. Technical Training: Encourage your administration, medical staff, and physicians to step in, adapt to, and test the EHR. This will allow each division to experience the EHR as they would on a daily basis.
2. Workflow Analysis: Ask the EHR vendor to do a personalized workflow analysis specifically for your practice’s specialty. Some will do it for free! Also, this is a great way to test the vendor’s knowledge of specialty–based workflows.
3. Proposal Review: Many times, vendors include additional or hidden costs in a final proposal, such as training, hardware, or more. These costs can really add up. To save yourself from future billing hassles, make sure you understand the upfront and ongoing costs before purchasing an EHR. Gifts should be a surprise; fees shouldn’t.
4. Site Visit: If possible, do a site visit with a practice already using the EHR you are considering. Try to choose a practice with a similar number of staff and providers, and in a similar specialty. Observing an environment comparable to your own practice is a great preview of how your practice will run on the same system.
5. Support & Implementation: Will the promised implementation and training be adequate for your staff? What about support? These are questions you should ask and follow up on with your EHR vendor. You will need a clear “yes” across the board if you want your practice to run successfully.
6. Demo: Investigate the entire workflow of the EHR. Don’t settle for just the note documentation. Involve all staff members in the demo so each individual can address his or her concerns.
7. Goals: Take into account the short– and long–term impact on your practice. How will the EHR improve your productivity and efficiencies, and will this improve your practice’s bottom line?
8. References: Make 5–10 reference calls with practices similar in size and specialty. Speak to existing clients and ask about their implementation, training, support experience, and how quickly their vendor responds. No feedback is more powerful than the opinions of actual system users.
9. Interoperability: Interoperability will be a key player with Stage 2 meaningful use, which moves the focus from just collecting information to sharing it. Make sure your prospective vendor has a solid and attainable plan for Stage 2, with the proper investment and staffing needed to make it a reality. Systems that have proprietary and overly complex data–capture models will struggle to meet the standards. These systems may require time–consuming programming changes in order to fulfill Stage 2 requirements.
10. Meaningful Use: Make sure you select a system that supports the critical administrative and clinical workflows of your practice. A system that cannot meet your unique specialty needs will severely diminish productivity and will offset the potential gains from meaningful use incentives.
11. Data: Make sure the systems you evaluate collect and manage data on your terms and with the least staff/physician interaction possible. Rigid, linear, point–and–click systems require far too many clicks and capture extraneous data that is not germane to the visit.
12. De-Install: As EHR adoption increases, so do EHR failures. Systems that were initially attractive may have been combined with a PM offering, or were “free” if a practice took on a company for Revenue Cycle Management (RCM). Many high–volume specialists compare these systems to running a marathon in wing–tips—they may be shoes but they are certainly not fit for running. In fact, they’re painful! Select a system that is easily adaptable, and therefore adoptable—you and your physicians will be happier because of it!

Is Your Practice at Risk of Submitting Fraudulent E&M Claims?

EHRs that increase Medicare reimbursement through cloning and “upcoding” templated notes have drawn attention from the highest levels of government—including the Attorney General, HHS Secretary Katherine Sebelius, the Office of Inspector General, RAC auditors, four members of the Senate, and four members of Congress. Collectively, they have instructed various government agencies to aggressively pursue providers who engage in this type of behavior.

Physicians: Is your practice at risk? Here’s what you need to know about the potential misuse of EHRs for E&M claims:

What Could Go Wrong?

  • “Upcoding”: If a provider notes a condition in a point-and-click EHR and that notation generates an E&M code—and the physician did not counsel, advise, treat or prescribe for that condition—it opens up the potential for fraudulent behavior.
  • Automated Coding: Some EHRs automatically assign E&M billing codes to different office visits. This may lead to incorrect coding if particular elements were not actually part of an examination.
  • Cloning: Some EHRs allow patient notes to be duplicated from one visit to the next. This may result in serious compliance issues if the cloned information is incorrect.

What Are the Implications?

  • Audits: CMS has explicitly stated they will focus on expanding RAC audits in 2013 to prevent incorrect billing. Medicare billing practices will also be reviewed more extensively to identify specific providers whose billing for expensive services exceeds the average. Many providers have assumed that the RAC audits apply only to hospitals. However, it was recently announced that RAC audits would be done in ambulatory practices, as well.
  • Prosecution: “Upcoding” is illegal and it leaves healthcare providers open to prosecution for fraud. For example, according to FierceHealthcare, 2 organizations paid more than $10 million to settle fraudulent E&M billing allegations in 2009. Additionally, the U.S. Department of Health and Human Services, along with the Justice Department, indicted 91 people in 2011 for playing a role in Medicare billing fraud.

How Can You Protect Your Practice?

The best way to protect your practice is to use an EHR that does not automatically generate billing codes and does not require the use of templates for documentation. An EHR that allows physicians to document unique, nuanced notes that accurately reflect patient health and the work performed during the exam provides the most protection from an audit and allows for superior patient care.

Servers and PCs-Aren’t They Just Computers?

In a previous post, we introduced you to our first guest blogger, Gregory Nizich from Custom Computer Specialists, Inc., with his article, “Why Are Servers More Expensive Than PCs—Aren’t They All Just Computers?” We hope you found the information beneficial. As promised, here is the continuation of his previous blog. Enjoy!

How is a virtual server different from a regular server?

In a medical practice, maximizing office space and minimizing operating cost are two critical factors that drive decision making. As practices grow, the number of physical servers also grows to accommodate the needs of the business.

For example, a practice may have a domain server, a practice management software server, an EMR server, an e-mail server, a file server, and a terminal server. All of these servers take up space, consume electricity, and require support. This is where a virtual server can help! A virtual server is a single “box” that has the brain power and storage capability of many servers, perhaps a dozen. The brains and storage, contained in the single box, can be carved up into individual servers.

When you look at the screen, the virtual server looks no different than the physical server. But in reality, all of the above servers are actually contained in this single box, which typically only requires a single second server “box” for backup. Reducing 6 servers down to 2 can save practices a lot of money. Less space is required, electrical expenses are reduced, and fewer moving parts mean lower support costs.

I hope this information offers you an understanding as to why servers cost more than PCs, why PCs cannot be used as servers, and when a virtual server may be the right choice.

Gregory Nizich
Healthcare Account Manager
Custom Computer Specialists

2012 Tax Break-Section 179: Deduct Your EHR Purchase

Doctors and Administrations: Don’t miss out on your 2012 tax break!

The purchase and use of an EHR (server-based solution) during calendar year 2012 may afford your practice tax benefits under Internal Revenue Section 179 and 50% Bonus Depreciation. Making an investment now—taking advantage of financing and tax benefits—makes good business sense.

Section 179 allows you to deduct the purchase price of equipment —like your EHR software and hardware purchases—from your practice’s gross income. It also offers a tax break to boost the financial benefits of purchasing new technology to:

  • Support physicians in providing enhanced patient care
  • Allow practices to maximize their purchasing power

Take advantage of this opportunity—make sure that your medical practice is leveraging the Section 179 deduction this year and invest in a user-friendly, intuitive EHR that has a proven track record for success!

Please check with your accountant for details and eligibility