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Cool is Great, but ICD-10 Is About Payment

I got the following email from a practice manager:

But here is a monster of a question for EMR/EHRs: In 510 days, ICD-10 and its 70,000 plus codes (as opposed to ICD-9′s 14,000 codes) will be on the necks of providers. How will the software handle that? It will have to keep both sets available, because old claims will still be under that system, and may even have to provide a “translator” function from one to the other. Not just a crosswalk, a decision rubric.

This is how the money gets made, and everyone wants to be paid. Cool may be awesome, but payment…well, that’s serious.

As my programmer daughter says, this is what computers do best, but a human has to program it to do that.

This comment is a really interesting one and reminds me of the hospital administrator I was with recently who talked about being overwhelmed with the administrative. ICD-10 is an example of the administrative that can be overwhelming and could have serious financial consequences if not dealt with appropriately.

Plus, the above comment highlights how many practices will be at the mercy of the EHR and other software programmers when it comes to ICD-10. I agree that ICD-10 won’t be an issue for many as long as the programmer does a good job implementing it. In fact, this is why the concept of dual coding ICD-10 is so important. However, as the linked article discusses, that’s not likely an option for a smaller clinic.

Either way, I’m interested in the core idea of being distracted by the shiny things so we miss out on the serious ones.

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May 8, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Filed Under: EHR  Electronic Health Record  Electronic Medical Record  EMR  Healthcare IT  ICD-10
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EHR Certification Revoked for EHRMagic

Yesterday HHS released news that they’d revoked the EHR certification of the EHRMagic-Ambulatory and EHRMagic-Inpatient EHR software. Looks like InoGard originally certified the EHR and they and ONC received information that had them retest the EHR software and it failed the certification re-test.

I think we all want government to hold bad actors accountable. So, it’s good to weed out EHR companies that aren’t doing what they should. However, they better also be careful. Imagine being a doctor of an EHR vendor whose EHR certification gets revoked. Does that mean that they have to give back the EHR incentive money the received? Those doctors trusted in InfoGard’s ability to certify an EHR vendor and InfoGard failed at that job. Should a doctor be punished for InfoGard’s failing? Now apply this to a hospital that uses a certified EHR and loses that EHR certification. That’s a multi-million dollar impact.

I guess EHRMagic better take down the info on their website that says they can get physicians $44,000 in EHR incentive money. Looking at their website, it makes me wonder who chose to use their EHR in the first place. That would be interesting to know.

Here’s the full press release from HHS on the EHR revocation:

Two electronic health records, previously certified as products to be used as part of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs, have had their certifications revoked. Farzad Mostashari, M.D., the national coordinator for health information technology, announced today that the products do not meet standards and providers cannot use these products to meet the requirements of the Medicare and Medicaid EHR Incentive programs.

EHRMagic-Ambulatory and EHRMagic-Inpatient, both developed by EHRMagic Inc. of Santa Fe Springs, Calif., no longer meet the EHR certification requirements. The EHRs must be certified by a certification body (ACB) authorized by the Office of the National Coordinator for Health IT (ONC) before regaining certification.

Both ONC and an ONC ACB, InfoGard Laboratories Inc. (InfoGard), received notifications that the EHRMagic products did not meet the required functionality and the products should not have passed certification. InfoGard analyzed the additional information from the notification and contacted EHRMagic, launching the ONC authorized certification body required surveillance activities. InfoGard concluded that it was necessary for the EHR products to be retested for select requirements. EHRMagic, Inc. participated in retesting and failed.

“We and our certification bodies take complaints and our follow-up seriously. By revoking the certification of these EHR products, we are making sure that certified electronic health record products meet the requirements to protect patients and providers,” said Dr. Mostashari. “Because EHRMagic was unable to show that their EHR products met ONC’s certification requirements, their EHRs will no longer be certified under the ONC HIT Certification Program.”

Information about ONC’s certification process for EHR technologies is available at http://www.healthit.gov/providers-professionals/certification-process-ehr-technologies.

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April 26, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Filed Under: EHR  EHR Companies  EHR Incentive  Electronic Health Record  Electronic Medical Record  EMR  EMR Companies  Healthcare IT  HITECH  Meaningful Use
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EHR Incentive Sequestration and Guidance on Meaningful Use Attestation

The CMS website has a great resource with answers to a number of FAQs. For example, here’s two questions that related to sequestration’s impact on EHR incentive and meaningful use attestation.

Question: Will incentive payments earned in the Medicare and Medicaid Electronic Health Records Incentive programs be affected by sequestration?

Answer: Incentive payments made through the Medicare EHR Incentive Program are subject to the mandatory reductions in federal spending known as sequestration, required by the Budget Control Act of 2011. The American Taxpayer Relief Act of 2012 postponed sequestration for 2 months. As required by law, President Obama issued a sequestration order on March 1, 2013. Under these mandatory reductions, Medicare EHR incentive payments made to eligible professionals and eligible hospitals will be reduced by 2%. This 2% reduction will be applied to any Medicare EHR incentive payment for a reporting period that ends on or after April 1, 2013. If the final day of the reporting period occurs before April 1, 2013, those incentive payments will not be subject to the reduction.

Please note that this reduction does not apply to Medicaid EHR incentive payments, which are exempt from the mandatory reductions.

Question: For the Medicare and Medicaid EHR Incentive Programs, how should an EP, eligible hospital, or critical access hospital (CAH) attest if the certified EHR vendor being used is switched to another certified EHR vendor in the middle of the program year?

Answer: If an EP, eligible hospital or CAH switches from one certified EHR vendor to another during the program year, the data collected for the selected menu objectives and quality measures should be combined from both of the EHR systems for attestation. The count of unique patients does not need to be reconciled when combining from the two EHR systems.

If the menu objectives and/or clinical quality measures used are also being changed when switching vendors, the menu objectives and/or quality measures collected from the EHR system that was used for the majority of the program year should be reported.

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April 25, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Filed Under: EHR  EHR Incentive  Electronic Health Record  Electronic Medical Record  EMR  Healthcare IT  Meaningful Use
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NY Patient Portal Prototypes and Voting

The NYeC has put together a patient portal design challenge to provide the best patient portal for New Yorkers. It’s a pretty cool challenge and they have 14 prototypes that are participating in the current voting. I’ve copied an email that contains more info on the challenge and the voting, but I thought it was a pretty cool thing to be able to see a number of different companies approaches to a patient portal. I wonder if some EMR companies will hire the portal designers directly.

As you may know, the New York eHealth Collaborative (NYeC) is building the Patient Portal for New Yorkers—a statewide website where New Yorkers will be able to securely access their healthcare records.

To create the most user-friendly portal design possible, NYeC hosted a design challenge earlier this year, calling on designers and developers to submit prototypes of what the portal should look like. Now they’re are asking the public to vote on the designs!

And now they want to hear from you—help shape the future of healthcare in New York State byvoting today.

After the public voting period ends on April 23rd, the top 10 finalists will be invited to demonstrate their prototypes to a panel of judges and a larger audience at 2 events: April 30th in New York City and May 2nd in Buffalo. You are invited to attend. As a result of these events, first, second, and third place will be awarded, concluding the design challenge.

To learn more about portal, vote, and to register, visit: http://PatientPortalforNewYorkers.org/

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April 15, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Filed Under: EHR  Electronic Health Record  Electronic Medical Record  EMR  Healthcare  Healthcare IT
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EHR Incentive Money and Sequestration Update

At HIMSS, the news was tweeted out about the impact of Sequestration on Meaningful Use and EHR incentive money. I’d seen little other details about the impact of sequestration on the EHR incentive money until now. CMS just sent out the following update on the mandated sequestration.

Mandated Sequestration Payment Reductions Beginning for Medicare EHR Incentive Program

Incentive payments made through the Medicare Electronic Health Record (EHR) Incentive Program are subject to the mandatory reductions in federal spending known as sequestration, required by the Budget Control Act of 2011.

Incentive Payment Reduction
The American Taxpayer Relief Act of 2012 postponed sequestration for two months.  As required by law, President Obama issued a sequestration order on March 1, 2013. Under these mandatory reductions, Medicare EHR incentive payments made to eligible professionals and eligible hospitals will be reduced by 2%.

Reduction Timing
This 2% reduction will be applied to any Medicare EHR incentive payment for a reporting period that ends on or after April 1, 2013. If the final day of the reporting period occurs before April 1, 2013, those incentive payments will not be subject to the reduction.

Please note: This reduction does not apply to Medicaid EHR incentive payments, which are exempt from the mandatory reductions.

The 2% will be a little annoying for a doctor’s office, but the 2% off the multi-million dollar EHR incentive a hospital receives is going to add up to a pretty penny. At least the information is out there so that hospitals can plan. Although, it’s not like you can stop the EHR implementation at this point in the cycle.

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April 11, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Filed Under: EHR  EHR Incentive  Electronic Health Record  Electronic Medical Record  EMR  Healthcare IT  HITECH
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Healthcare Document Management Infographic

I’m always a fan of the various healthcare infographics that are put out and the same is true from the healthcare document management infographic that was published by Globodox. The infographic highlights one of the myths that exists in healthcare that once you go EHR that you’ll be done with paper. Unfortunately, you’ll still have a lot of paper to deal with in the process of going paperless. So, document management of some sort is a really important part of any EHR implementation.

I find the HIPAA violation section interesting, but I’m not sure I think going electronic actually helps solve a lot of the breach problems that they list. I don’t personally believe that electronic records makes more HIPAA breaches happen, but I do believe that the size of the breaches increases dramatically in an electronic world. 10,000 charts could be stored on a small thumb drive that can be easily lost. Try losing 10,000 paper charts. You get the idea.

Now, without further ado, the healthcare document management infographic:
Healthcare Document Management Infographic

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April 2, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Filed Under: EHR  Electronic Health Record  Electronic Medical Record  EMR  Healthcare IT
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Extormity Announces Oh Well Initiative, Plans to Interoperate with Itself

The great people at Extormity have put out another great announcement (embedded below). They’re really taking healthcare interoperability to a new level with their ability to share health records at “distances up to 65 feet.” The satire is terrible since there are still many EHR vendors that can’t share data even that far.

Enjoy the great write up!

Extormity Announces Oh Well Initiative, Plans to Interoperate with Itself

On the heels of the HIMSS conference, electronic health record vendor Extormity today announced that it will begin making its own solutions interoperable as part of what calls its Oh Well effort.

“It has become increasingly clear that interoperability is a buzzword we must pay attention to,” said Extormity CEO Brantley Whittington from a corporate planning retreat in Monaco. “Our attitude is ‘Oh Well’ we clearly have to make a token gesture, so we are planning to make every Extormity application interoperable at distances up to 65 feet.”

“What separates this initiative from other relatively banal announcements we have made in the past is the fact that this level of interoperability will no longer require complex and time-consuming integration,” added Whittington. “The only customer requirement is a sizable check.”

Extormity also announced that it has reserved more than 50 percent of the exhibit space for HIMSS14 in Orlando. “In the past, we have been low key at HIMSS, preferring to host lavish off-site parties,” said Whittington. “Next year, we are doing an about face and we plan to own the conference. As attendees enter our booth, they will find themselves trapped in a maze that is all but impossible to escape without signing an agreement. However, there will be jumbo shrimp, cocktails and constant entertainment by 80′s arena bands with at least one original member.”

About Extormity

Extormity is an electronic health records mega-corporation dedicated to offering highly proprietary, difficult to customize and prohibitively expensive healthcare IT solutions. Our flagship product, the Extormity EMR Software Suite, was recently voted “Most Complex” by readers of a leading healthcare industry publication. Learn more at www.extormity.com

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March 18, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Filed Under: EHR  EHR Market  Electronic Health Record  Electronic Medical Record  EMR  Healthcare IT
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HIMSS13 Healthcare IT Leadership Survey Infographic

The 2013 HIMSS annual conference is complete. There were 33,920 total attendees and 13,585 professional attendees at the event and I heard over 1200 exhibitors. Some pretty amazing numbers. The attendees is lower than last year in Las Vegas, but the exhibitors are up. I’ll be interested to see how those numbers play out with HIMSS 2014 in Orlando.

At the conference HIMSS put out it’s 24th Annual HIMSS Leadership Survey results and shared the inforgraphic below.
HIMSS Leadership Survey Infographic

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March 7, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Filed Under: EHR  EHR Market  Electronic Health Record  Electronic Medical Record  EMR  Healthcare  Healthcare IT  Healthcare IT Conferences

Extormity Touts Customer Dissatisfaction, EHR Switching Statistics

I guess I really should post this Extormity press release to my EMR, EHR and Health IT News site (where you’ll find all the various press releases that are coming our before, during, and after HIMSS), but this is so much more than news. For those not familiar with Extormity, it’s kind of “The Onion” of Healthcare IT. A fictitious company that highlights many of the absurdities in the healthcare IT and EHR world. Although, the irony is how well they mix the reality with the absurdities.

Without further ado, the latest Extormity News which just hit my email inbox:

Electronic health record vendor Extormity today announced that nearly 75 percent of its existing customer base reports being dissatisfied, extremely dissatisfied or contemplating suicide based on the decision to implement the Extormity EHR solution. Further, Extormity expects nearly 40 percent of its clients to de-install their solution in 2013 and switch to another vendor.

Citing a recent study which indicated that nearly 20 percent of EHR users could be switching out their first choice EHR this year, Extormity CEO Brantley Whittington stated “We are ecstatic that unhappiness levels among our clients clearly outpaces the industry average.”

“Even as analysts are expressing concern with these statistics, these findings have generated incredible buzz about Extormity – resulting in a disproportionate share of media attention,” added Whittington. “Better yet, the focus on dissatisfaction levels has obscured questionable financial dealings, several catastrophic medical errors linked to flawed clinical decision support algorithms, and more breaches than you can shake a stick at.”

While the projected de-conversion rate could be considered alarming, Extormity officials remain bullish on the company’s future. “While much of our installed base is fleeing the good ship Extormity, we are winning new clients at a record pace as providers head for the exits with other vendors who also made expensive empty promises,” added Whittington. “When one considers early termination penalties, exorbitant costs for data conversion and the steep hourly rates we charge clients who are transitioning away from our EHR, we expect record profits which will fund the construction of our new corporate headquarters.”

About Extormity

Extormity is an electronic health records mega-corporation dedicated to offering highly proprietary, difficult to customize and prohibitively expensive healthcare IT solutions. Our flagship product, the Extormity EMR Software Suite, was recently voted “Most Complex” by readers of a leading healthcare industry publication. Learn more at www.extormity.com

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February 27, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Filed Under: EHR  EHR Companies  Electronic Health Record  Electronic Medical Record  EMR  EMR Companies  Healthcare IT
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Another View of the Coming Physician EHR Revolt

In a LinkedIn response to my post on The Coming Physician EHR Revolt, Barry Schechter offered the following candid comments:

First off I feel bad for the Drs. Then as we had in another thread the big red flag is the medical billing aspect of EMR and who benefits from that billing data. Then we have the difficulties in sharing the pertinent data allowing patients to get comprehensive care, sometimes in the same building. Then we have HIPAA which has become a greater boondoggle and less effective than TSA at airports or Homeland Security. Small wonder that Drs want to revolt. Then we can add the singleness of opinions about what an ICD really means and whether it is or isn’t ethical to copy and paste. The billing engine drives this bus and the EMR is nothing more than an auditor’s or payer’s window in to being able to justify rejections. It’s also a way for payers to eliminate the errors that come up through paper billing and given that make it easier for payers to “check up” on billing practices when auditing EMR. The bigger backlash will be from the patients as they realize that EMR is not being used to provide better medical care and that all the data is being zealously protected and not shared among their care providers. Patients will have even more cause to scream when insurers use the billing engines to eliminate CPT and ICD that are below a threshhold of service (I see that coming).

I think Barry is right that many doctors fear that EHR is just a way to track their billing and screw them over in the end. Whether this fear is founded or not, I’ve heard it expressed by a number of doctors.

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February 15, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Filed Under: EHR  Electronic Health Record  Electronic Medical Record  EMR  Healthcare IT
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