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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.

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 and Google Plus.

Guest Post: More Physicians Joining the EHR Trend

Elise Redmann is currently a student at the University of South Florida where she is earning her Bachelor’s degree in business advertising and international business. She works as a writer with the Jacksonville University School of Nursing Online RN to BSN online programs where she covers topics on healthy living. You can follow her @EliseRedmann712 on Twitter.
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An electronic health record (EHR) is a digital record that typically captures a variety of health and personal information. An EHR can include a patient’s medical history, including test results, medications, allergies, illnesses and other conditions. It can also include personal details, such as demographic and billing information.

The use of EHR systems is on the rise as many hospitals and other healthcare providers replace paper record systems with digital records. According to a December 2012 report by the National Center for Health Statistics, 72% of office-based physicians used an EHR system in 2012, up from 48% in 2009.

Some of this growth has been fueled by the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, which offers healthcare providers incentives to implement EHR systems. In order to qualify for these incentives, providers must demonstrate that they are “meaningfully using” certified EHR systems by meeting certain objectives, many of which represent key benefits of implementing electronic health record systems.

Collaborative Care Made Easier

The primary advantage in transitioning to electronic health records is the ease with which physicians can review patient health records across time and across multiple providers. Since EHR systems capture medical data over the patient’s lifetime, physicians can search the digital records or review a composite of a patient’s medical history without resorting to searching through paper record archives.

In addition, physicians and other healthcare providers with access to an EHR system can more easily collaborate with each other and provide consistent and improved patient care since all involved can review each other’s notes, diagnoses and treatments.

Safer and Faster Prescription Processes

An EHR system can vastly improve safety and workflow efficiency relating to prescription medication. Once a physician enters a prescription into the system, it becomes part of the patient’s health record. The system then checks the medication against the patient’s list of other medications and allergies, and issues the physician with an interaction or contraindication warning. If there are no problems with the medication, the system will then automatically send it to the patient’s pharmacy.

The systems help to ensure that patients receive the medication they need and it also saves the physician time in reviewing and updating the patient’s records and sending the prescription to be filled. In addition, it monitors drug usage and helps eliminate errors associated with illegible handwriting.

Putting Patient Data to Good Use

Digital health records make it not only possible but relatively effortless for physicians to generate an array of reports for individual patients, as well as on their overall practice. Aggregated data can be used to publish treatments and outcomes, while individual data can be given directly to patients. Physicians can provide patients with an electronic copy of their health information and can also quickly produce clinical summaries for patients after each visit.

Digital Charting

Digital charts using an EHR system allow physicians and nurses to be comprehensively informed about a patient’s health history, ensuring proper medical care. Digital charts store patient history and demographic information, and maintain an up-to-date list of current and past diagnoses and treatments, as well as an active medication list.

Digital records can also reduce costs. Chart rooms could be converted to revenue-generating spaces and the increased efficiency means that physicians can see more patients without working longer hours.

Patients benefit from digital charting as they can receive immediate answers about medical matters. In urgent or emergency situations, physicians can access records remotely using an Internet connection, giving them the ability to respond quickly and correctly.

With so many benefits to physicians and patients, implementing an EHR system makes sense. With EHR systems now in such wide use, patients are increasingly seeking out physicians who incorporate electronic health records into their practices.

December 28, 2012 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 and Google Plus.

The Impact of EHR Certification

In the comments of my post on EMR and EHR titled EHR Vendors Using EHR Certification Excuse, Jeff offered a frank comment about the realities EHR vendors face in this current climate:

I went through EHR certification for a EHR product – for the sake of this discussion it can remain nameless as you can insert any EHR name and it will share the same issues. The process was cumbersome and I agree is not worthwhile for our clients. However at least 90% of our clients were requesting it and all of our sales pipelines say they required it. The interaction you describe I have had. I don’t think it’s the fault of us as a vendor as much as the short sightedness of the committee that created the certification rules. We had to implement fields/screens/buttons that served no purpose in the type of practice we supplied our software to. That did not matter to the certification proctor, we had to show it or we failed and lost a lot of money. Getting certified threw off our development cycle at least 6 months. During that time we had to push off many good customer requested enhancements. In hindsight would our customers prefer we did not get certified – probably, but could our company take a chance at not being able to renew contracts or get new sales. No way, not for a government mandated push.

This reminds me of a video I recently saw that asked the question, “What do we want EHR certification to do?” The problem here is that I think everyone has a different answer to that question. Until we define what EHR certification should really accomplish, it’s hard to make criteria that are beneficial and easy to understand. In the rush to meet the regulatory requirements I think we missed creating the bigger vision of why we’re doing EHR certification at all. That’s why we’re where we’re at today.

October 24, 2012 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 and Google Plus.

REC Numbers for REACH (Minnesota and North Dakota Doctors)

For those not familiar with the RECs (Regional Extension Centers), REACH, a nonprofit federal Health Information Technology Regional Extension Center, helps providers and clinics throughout Minnesota and North Dakota to either optimize current EHR or implement EHR into their practice. They aim to help different providers and clinics to reach stage 1 meaningful use in a year or less. REACH offers many services in their program to reach this goal, such as readiness and meaningful use assessments, contract review and coaching, organization and workflow redesign, and basic report writing.

REACH recently put out some numbers about their EHR reach that were quite interesting. Currently more than 4,700 providers and 513 clinics are benefiting from the services offered by REACH. They have reached above their goal by helping 3,600 priority primary care providers (this goal was exceeded by 1,149). Below are some recent REACH numbers:

  • 4,749 priority primary care providers
  •  3,541 e-prescribing and quality reporting
  • 301 having achieved meaningful use
  • 104 critical access/rural hospitals (84% of eligible hospitals
  • 33 e-prescribing and quality reporting
  • 11 having achieved meaningful use

Below is a really interesting map that shows the locations of clinics and hospitals currently served by REACH.

I appreciate RECs like REACH that are putting out the data for how many doctors they’ve helped. What do people think of the RECs now?

June 7, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

Healthcare Mandate and Healthcare Reform Infographic

The US news world is covering this week’s supreme court hearings on the constitutionality of the healthcare reform law, also known as the Accountable Care Act (ACA). No doubt the ruling of the supreme court could have a really major impact on healthcare reform in this country. As best I can tell, all things seem to be pointing at the law remaining in place, but when you’re dealing with a few people deciding something this important things can change quickly.

I’ll admit to not being an expert on the details of ACA and healthcare reform. Plus, each side is spitting out so much rhetoric that it’s hard to really get a hold of the real details of what is going to happen with this new law and what the long term impacts from it will be. Seems like rational thought and reason is going out the door as emotions and partisan lines take over.

I did see this healthcare reform infographic from AHIP hitting my Twitter stream a few times. It analyzes an important nuance of ACA and healthcare reform. If you cut out the mandate for health insurance and leave in the other ACA market reforms, then as this graphic shows the insurance premiums go up and the uninsured increases as well.

This is basic rules of health insurance really. The ACA market reforms basically add a bunch of unhealthy patients to the insurance companies patient list. That’s why insurance companies were denying them coverage in the past. It seems the hope is that the health insurance mandate would also add a group of healthy patients as well since they could help offset the cost of the expensive patients.

This doesn’t have all that much to do with EMR, but it’s an incredibly important topic in healthcare that could fundamentally change the landscape. So, I thought it worth talking about.

One thing should be made clear. The ACA is different than the ARRA/HITECH legislation. I believe there is a little bit of healthcare IT money in the ACA, but when you talk about EHR incentive money you’re really talking about ARRA/HITECH. Only ACA is going to the supreme court. ARRA/HITECH could be effected by future legislation, but is a separate and distinct bill.

March 26, 2012 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 and Google Plus.

Psychiatry Meaningful Use Videos

I probably should post these on my EMR and EHR videos website, but since they can’t be embedded I figured I’d just post about them on here.

The company Valant Medical Solutions has posted 4 videos that go through the various meaningful use requirements. Of course, I’m sure that many of you are thinking that’s not all that interesting. Plus, the videos are quite specific to the Valant EHR solution. You’re right on both accounts.

There are a number of reasons I’m posting them anyway. First, I always find it interesting to see how an EHR vendor is trying to help their doctors achieve meaningful use. Second, the principles of meaningful use are the same regardless of EHR vendor so even if the details are specific to the Valant EHR you can still learn about the details of meaningful use. Third (and maybe most important), these are the first videos that I’ve seen address meaningful use for psychiatry.

Hopefully all you psychiatrists out there that want to show meaningful use of your EHR will take a look and get some value out of these videos.

September 14, 2011 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 and Google Plus.

Cerner Meaningful Use Incentives Total $2.2+ Million

Today, some of the numbers for users of the Cerner certified EHR (ambulatory clients) came across my desk and since I’m a number lover, I thought I’d share.

Cerner Ambulatory clients have secured $2.2+ million in combined Medicare and Medicaid Meaningful Use incentive funds from 16 states. More than $1.5 million of that $2.2+ million is in Medicare EHR incentives.

More than 115 Cerner Physicians have successfully attested to the Centers for Medicare and Medicaid Services (CMS) EHR incentive program.

Looks like Cerner is planning to use @Cernerphysician and the Cerner Facebook page to publish updates like this in the future.

Now I must admit that I’m interested to know the Cerner EHR Stimulus numbers for the acute care settings.

If you know of other EHR vendors that have released their numbers, let me know and I’ll publish them in a future post.

August 31, 2011 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 and Google Plus.

New EHR Vendor Program for Health IT Work Force Development Program Students

EMR Thoughts has had a lot of students from the Health IT Work Force Development programs coming to the site after I did my post about the HIT Pro Competency Exam. One of the most common complaints I’ve heard from these students is how do they get experience working on an EHR system. Many are even willing to work for free to gain experience and they say they can’t find anyone who will teach them.

These discussions is why I found a new Certification Program for HITECH IT Workforce Program members from iChartsMD so interesting. Certainly there is a specific EHR vendor (in this case iChartsMD) behind this certification, but depending on how they structure the program it could provide these students some first hand experiences using that EHR. For those who don’t have any EHR experience this might be a great move for them.

I also can’t help but wonder if this isn’t a great way for iChartsMD to find smart people that they can hire into their company in implementation and support roles. I’m sure many of these HITECH workforce program participants would welcome a job working for an EHR vendor. Seems like a decent win win to me.

August 4, 2011 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 and Google Plus.

Health IT and EMR Spending to Reach $40 Billion

The U.S. health IT market is forecast to grow at a compound annual growth rate (CAGR) of around 24% during 2012 to 2014, according to a study from RNCOS, a global market research and information analysis company.

The report, U.S. Healthcare IT Market Analysis, which was published earlier this month, said the health IT industry is expected to surge to $40 billion by the end of 2011. The growth will be driven not only by healthcare reform and the implementation of e-health systems, but also by a population that will demand and increasingly be able to afford quality services.

Segmenting the market into IT hardware, IT software, and IT services, the report notes that IT hardware accounted for 65% of the total market at the end of 2010. It also said the mandatory use of electronic health records (EHRs) has boosted the market for software. As a result, the healthcare IT software market will increase in revenues from $6.8 billion in 2010 to $8.2 billion in 2011. -Source

These are some interesting numbers to consider. I found the split between IT hardware and software to be quite interesting. The $1.4 billion growth in the healthcare IT software market seemed a bit low too. At least when you compare on the amount of EHR stimulus money that is suppose to go out. I’d have to run some numbers to figure out how the projected $36 billion of EMR stimulus money will be spent over the various years of the program, but it seems like it should be more than $1.4 billion this year. Plus, the $1.4 billion increase is all healthcare IT software and not just EMR. I assume this would mean PACS software, Pharmacy Software, Lab software, etc.

There’s no doubt that the healthcare IT industry is growing. Amazing to think about so much money flowing into healthcare IT.

May 25, 2011 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 and Google Plus.

Likely Delay in Meaningful Use Stage 2

Everyone that lives and breathes EMR and meaningful use has been seeing the people calling for meaningful use Stage 2. Jim Tate posted on HITECH Answers some new proposed timing options for meaningful use stage 2 that came out of the HIT Policy Committee and meaningful use workgroup. Of course, this committee is just a committee and just makes recommendations, but most of their recommendations have been taken.

Here’s Jim Tate’s summary of the MU stage 2 delay:

It is now being fully recognized that the move from entry level Stage 1 to Stage 2 will not be simple small step. Stage 1 was designed to facilitate buy in from vendors, EPs and EHs. Stage 2 will be where it gets real and the present timeline is simply not sufficient. The MU Workgroup has proposed several possible timing options to the current plan. All signs point to the creation of more elbow room in Stage 1.

On Jim’s post, he also has the chart he posted that showed the various meaningful use stage 2 timing options. Looks like meaningful use stage 2 is in for a delay.

May 12, 2011 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 and Google Plus.