Does the MU incentive out-way the cost of an EMR?

Because of MU or meaningful use incentives, many companies are quickly setting up digital health information without handling the individuals and procedure modification that will make sure long-term success. To post-pone workflow changes and procedure upgrades can cause re-work that costs far more than meaningful use of motivation expenses. Despite the current difficulties, there are many effective companies that are doing well and are quite innovative in their use of digital wellness information or EMR’s. They are now able to innovate and make aggressive advantage. Below are some factors that can exceed MU incentives.

Focusing on technological innovations

The stress to live quickly is essential and we certainly want to restore some of our investment dollars through meaningful use rewards. But appropriate style does not have to be delayed. It is a matter of having the know-how and concentration to decrease danger and improve benefits in our venture plan.  We should make sure to avoid these stumbling blocks that can wipe-out our MU payments.  Focus only on technological innovation compared to workflow style. Instead, we should know what to get out of our EMR and then style for it. We should develop our electronic wellness information to improve individual proper care results, fulfill and stand above change. Too many companies today are building their EMR’s with a team who do not have full knowledge of the medical proper care company. While these technologists are vital to achieve, they must associate with the company and scientific management of the company.  Workflow style has to be done by the individuals who perform on a regular basis as they know the details better and will be attributed for modification and program usage. But if the workflow is not developed properly, our meaningful use objectives are at risk. The proper workflow needs a doctor and health professional involvement at every step of the way.

Workflow Style 

Workflow style is not basically moving from one process to another. Workflows include business specifications, individual proper care results, company rules and traditions, decision-making and interaction methods. Our achievements are relying on appropriate style by the appropriate individuals. Technology investment strategies alone will not generate EMR profits but our individuals will.  These individuals’ investments go beyond basically teaching our team to learn the setting up applications; it requires knowledge on company specifications, authority development and modifies management best methods. Such investment strategies are only but not also requiring investment strategies of time, energy and authority involvement. Develop a control lifestyle that involves workers and places a high concern on their growth. The wall between the medical proper care company and medical proper care IT is coming down so abilities on both factors need to advance to remain aggressive in this modifying fast market. Our existing professional group and our EMR group need information about what is technologically possible.

Live versus Adoption

Transformation happens when the company details the individual issues. This requires strategy and interaction around the changes that will happen because of incorporation. The projects, individuals, and functions are all suffering from the EMR.  An effective adopting program guarantees the software is used in the way the execution is designed and is also on the direction to the company's perspective and objectives. Change control is the biggest insurance to make sure the company defines guarantees advantages as incorporation, care provider cooperation, enhanced individual proper care, performance upgrades, MU conformity, ACO etc. To be effective, technological innovation modify must be equalled up with program adopting and requisite end-user actions modify.  Due to the routine of go live, this is often put on automated but it actually requires continuous perform and dedication to develop new routines. 

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Understanding Search Engines to Improve Your Searches

A larger number of physicians are now relying on Google to help them find information sources to help them diagnose or treat their most difficult cases. In this article we explain how to make online searches more effective by writing better search queried, thus reducing the time it will take to find articles, information sources and websites relevant to what you are looking for.

Firstly let’s understand what a search engine is and how it works. A search engine is a system that searches the Internet. Search Engines help users sort through the huge amounts of information on the Internet to find what they are looking for. A user type-in words or phrases also called a “search query”, and the search engine looks for those words or phrases in Web sites and returns a listing of links to relevant pages as a result.

One of the challenges which most people face when using search engines is that a large number of results in response to a search query are unrelated to what the user is intending to research. There are, however, some ways to make searching more effective.

Try to meet the search engine halfway by refining your search before you begin.

It is important before starting a search to spare a thought in your mind over what sort of information you want. Split your search topic into key concepts and let each be a search phrase. Enter the smallest possible subset that describes what you want. The words you choose will determine the information you find. Try to use words that are specific and describe what you are looking for in unique ways.

Example: If you want to find articles on “Acute Pain in the Chest “, don't enter the keyword "articles". See what more can you do with the keyword "Pain in Chest." 

A search for Articles on Acute Pain in the Chest can be carried out using the search phrase:

“Articles on Acute Pain in the Chest”

But the following search result will actually turn out to be better

“Acute Pain in the Chest”

Anticipate the answers

Before searching, try to imagine what the ideal page you would like to access would look like. Think about the words the articles heading would contain. Think about what words which would be contained in the first couple of sentences of the article that you would consider useful. Use those words, or that phrase, when you enter your query.

Keeping this in mind, if you can rewrite the previously entered search query to something which contains a part of the what the final page would contain, you are bound to get even more accurate and thus more meaningful results. 

A medical article on such a topic must contain the words cardiac, heart.

So refine your query still, search for Articles on Acute Pain in the Chest, using the search phrase:

Acute Pain in the Chest cardiac heart

Tip: Adding some words which should be expected to be found in the ideal content to your search phrase will help the search engine provide more relevant results.

Use the available search refining options

Search engines in addition to basic keyword searches allow you to refine your searches using advanced techniques.

These techniques are actually quite simple. Let us look at these below

USING BOOLEAN OPERATORS

Search engines allow the use of Boolean Operators to refine a search. Here the search Query is made up of keywords connected by OR, AND or NOT. You can search more effectively by using these connecting words which are supported but most online databases and search engines.

Using AND will retrieve all records containing both words on either side of AND

E.g Diabetes AND Naturopathy

This will retrieve all records containing the words Diabetes and also the word Naturopathy

Using OR will retrieve all records containing either or both words on either side of OR

Cancer OR Malignancy

This will retrieve all records containing the words Cancer and also the records containing the word Malignancy

Using NOT will retrieve all records containing the left word/phrase and Not containing the words/phrase on the right side of NOT

For e.g. If you want to find out about Alzheimer's care and community resources, you want to filter out the results which will come for Alzheimer's and be about the symptoms and prognosis. To obtain results only pertaining to support and community groups and not detailing the symptom the search query can read

"Alzheimer's" AND "support groups" AND "resources" AND NOT "symptoms."

IMPLIED BOOLEAN

In many search engines, the plus and minus symbols can be used as alternatives to full Boolean AND and AND NOT. The plus sign (+) is the equivalent of AND, and the minus sign (-) is the equivalent of AND NOT. There is no space between the plus or minus sign and the keyword.

For e.g.

If a specific term must exist in your search result, use the + symbol before the term in your search query

+ Doctors + Chicago

This will return all links with both Doctors and Chicago on the page.

If you want to exclude a term from your search results use the – symbol before the term in your search query

+Doctors +USA –Chicago

This will return all links with Doctors and USA but not Chicago.

PHRASE SEARCHING

Phrase searching is a powerful search technique for significantly narrowing your search results. If you want to perform a more specific search place quotation marks around it and search the phrase instead of the individual words. This tells the search engine to only retrieve documents in which those words appear side-by-side.

For e.g.: If we are searching for nursing schools in chicago and we use the search query

“Chicago nursing schools”

This will retrieve pages with the words in the exact order as specified within the double quotes.

FILETYPE SEARCH

File type searches empower you to search for information in the file formats that you desire. In case you are looking for powerpoint presentations on DNA Sequencing, the following search query will narrow the searches down to the ones which are available as power point presentations

filetype:ppt +DNA +Sequencing

URL SEARCH

The Url search limits the results to pages where the keyword appears in the website address. A Url search can narrow very broad results to web pages devoted to the keyword topic.

For e.g. Searching for asthama related pages from the Medlineplus database can be carried out as follows

url:"http://www.nlm.nih.gov/medlineplus/" AND asthama

WILDCARDS

Wildcards such as * which refer to anything can be used to add flexibility to searches.

For e.g in case the search query is

(hiv or aids) and pregnan*

The search engine will Use the * to mean anything . Thus the results will contain both tose links which contain the keyword pregnant as well as those links which contain the keyword pregnancy

Take advantage of “Find Similar Sites”

A useful option that many search engine sites are now offering is that one can "find similar sites," to the ones that come up in a search result listing. Essentially what the search engine is offering is a way to help the search engine move in the right direction.

Summarizing:

• Try to meet the search engine halfway by refining your search before you begin.
• Adding some words which should be expected to be found in the ideal content to your search phrase will help the search engine provide more relevant results.
• Use the available search refining options.
• Use Boolean Searches
• Use Phrases to create more specific search queries
• Use Wildcards to add flexibility to your searches
• Use File type searches to narrow your search to the file formats that you desire
• Use Unique Terms When Possible to Retrieve More Specific Results
• Take advantage of “Find Similar Sites”

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Features in Practice Websites which increase Patient Satisfaction

An important part of managing a patient over a long period of time is communicating with the patient. Most follow up cases in medical practices have niche requirements and consequently patients have certain expectations from their physicians. Also a happy patient is a physician’s most powerful marketing asset. Practices should strive to provide for such patients by offering services which improve the quality of service they perceive, which in turn will increases their satisfaction.

A well planned and feature rich practice website allows physicians to assist patients in their day-to-day living by providing timely solutions for all their health queries even after a visit. For a patient, this continued access to expert medical advice via simple online tools is one of the most cherished features of any e-practice.

Despite best efforts, many patients make errors while following medical advice. Many times, follow-up patients have new queries they wish they could simply share with their physicians. A large number of patients also do not ask new questions just because they don’t want to look stupid in front of their physicians! These patients are often unsure of the importance of their queries and generally procrastinate visiting their physicians for answers. Sometimes new complaints crop up which may or may not affect the ongoing medical management. The internet, via a medical website, allows physicians to clarify many such small doubts these patients face while following medical advice. A timely word of advice can save these patients a whole lot of pain, literally and figuratively. Important issues which may arise during such advice can be solved by arranging for a new visit.

There are a number of ways medical websites and integrated web 2.0 tools can be used to help physicians improve patient-physician communications and thus decrease the morbidity among patients. Let’s look at five such applications:

Online Chats

Chatting on the internet is something most patients are comfortable with. Medical websites can have widgets which allow patients to directly chat with the physician or the physician’s representative. This is a common and simple to add functionality within any medical website. Patients can be given pre-decided timings (say, 9 p.m - 10 p.m on Mondays, Wednesdays and Fridays) when the physician shall be available for the chat. Such chat transcripts can then be appended to the electronic medical record of the concerned patient. More people can be added to chats so as to allow group discussions (e.g: Friday evening hour long chat session for all Pregnant women, in case of gynae practices).

Contact Forms and Feedback Forms

Medical websites allow all registered members (i.e. follow-up cases) to access some parts of the website which are meant only for them. A simple form is embedded within this secure area through which a follow-up patient can ask a question. These questions are then directed to the physician’s email address. The physician can answer such questions securely via email or even ask the patient to book an appointment if required. Ideally, physicians should create an email id purely for answering queries of follow up cases. This will help in segmenting all electronic medical communications between physicians and patients. All such queries are also automatically added to electronic medical record of that patient.

Facebook Groups

After email, Facebook is the most commonly used online platform for communications. physicians can easily use this platform (by forming closed groups) for answering some of the common queries by their patients. All follow up patients who share their primary email id can be added to specific closed groups on Facebook. These patients can post their queries on the group wall (which is not public and viewable only by group members) or send it as a direct message. Answers which have general significance for all patients can be posted on the group wall (e.g.: I am taking Metoprolol XL 50 mg once daily for my hypertension. I am scheduled for a tooth extraction next week. What precautions should I take? ). Personal queries can be answered via direct messaging. Urgent and important issues can be simply escalated to a telephonic conversation. Over time, such a Facebook group shall mature into a powerful resource for all new members. 

Video Chat

Questions which require visual inputs (like appearance of rashes or swelling on hands and feet) can be handled by using Video chat within Facebook. Important advice can be reinforced by typing it into the chat area so as to create a transcript document of the encounter. There are medical social media guidelines published by many international organizations which can be followed for all such patient-physician communications on Facebook.

eVisits using Skype

Physicians can also use Skype and payment gateways like PayPal to organize revenue generating e-visits by follow-up cases who find it difficult to physically visit the clinic premises at regular intervals. This is especially the case with geriatric and physically challenged patients.

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What is Meaningful Use?

The purpose of the Healthcare IT incentive program is not static adoption of EHRs. The program has been devised in a manner that incentivizes only the “meaningful use” of your EHR system. Simply put, your practice will be eligible for the $44,000 incentive payment ONLY if it is able to actively utilize the EHR for improving the quality of care by satisfying certain federally set criteria. These criteria are called “Meaningful Use Objectives”.

Meaningful Use objectives have been defined in order to allow the progress of Healthcare IT and its impact on the National Healthcare System to be measured in terms of quality and quantity. It encourages the active adoption and implementation of health information technology by rewarding practices that are able to successfully incorporate the EMR in their daily workflow, using it to their full potential for delivering higher standards of healthcare.  

Meaningful Use is a phased program. It consists of three stages and the successful implementation of each stage is linked to incentive payments to be received for meeting the requirements of that stage.   

Stage 1: Data Capture (2011-2012)

This stage focuses on electronically capturing patient health information in a structured digital format using your EHR and utilizing this information for clinical purposes as well as communicating it for care coordination to other providers. If your first year of payment is 2011, you must satisfy the requirements of this stage in your first and second years of payment, i.e, 2011 and 2012, to receive the incentive payment.

This stage divides the objectives into two groups:

   1. Core group of 15 mandatory objectives
   2. Menu Set of 10 objectives from which physicians can choose any 5

Stage 2:  Data Aggregation and Exchange (HIE) (2013-2014)

This stage builds on the objectives of Stage 1 to focus on using health information technology to improve the quality of healthcare at the point of care. It also involves electronic and digital exchange of structured medical information among providers. This includes computerized physician order entry or CPOE and electronic transmission of diagnostic test results and other data required for clinical and medical support services.

Stage 3: Data Use to Improve Outcomes (2015)

Stage 3 focuses on utilizing the structured medical data made available in the earlier stages to improve healthcare quality and outcomes. This stage lays emphasis on the macro aspect of the healthcare system by encouraging support for national high priority conditions, emergency medical crises, self management tools for patients, access to patient medical databases and improvement in overall standards of healthcare delivery and population health.

Given below is a list of the Core and Menu Set Criteria required to be satisfied in Stage 1.

15 Core Criteria

[1] Objective: Use CPOE for medication orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines.
Measure: CPOE is used for more than 30% of all unique patients with at least one medication in their medication list seen by the Eligible Professional (EP) have at least one medication order entered using CPOE. (Exclusion: Any EP who writes fewer than 100 prescriptions during the EHR reporting period)

[2] Objective: Implement drug-drug and drug-allergy interaction checks.
Measure: The EP has enabled this functionality for the entire EHR reporting period.

[3] Objective: Maintain an up-to-date problem list of current and active diagnoses.
Measure: More than 80% of all unique patients seen by the EP have at least one entry or an indication that no problems are known for the patient recorded as structured data.

[4] Objective: Generate and transmit permissible prescriptions electronically (eRx).
Measure: More than 40% of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology.

[5] Objective: Maintain active medication list.
Measure: More than 80% of all unique patients seen by the EP have at least one entry (or an indication that the patient is not currently prescribed any medication) recorded as structured data.

[6] Objective: Maintain active medication allergy list.
Measure: More than 80% of all unique patients seen by the EP have at least one entry (or an indication that the patient has no known medication allergies) recorded as structured data.

[7] Objective:  Record the following demographics: preferred language, gender, race, ethnicity, date of birth. 
Measure: More than 50% of all unique patients seen by the EP have demographics recorded as structured data.

[8] Objective: Record and chart changes in vital signs: height, weight, blood pressure, calculate and display body mass, plot and display growth charts for children 2-20 years, including BMI.
Measure: For more than 50% of all unique patients age 2 and over seen by the EP, height, weight, blood pressure are recorded as structured data. (Exclusion: Any EP who either see no patients 2 years or older, or who believes that all three vital signs of height, weight and blood pressure have not relevance to their scope of practice.)

[9] Objective: Record smoking status for patients 13 years old or older.
Measure: More than 50% all unique patients 13 years old or older seen by the EP have “smoking status” recorded as structured data. (Exclusion: Any EP who sees no patients 13 years or older)

[10] Objective: Report ambulatory quality measures to CMS or the states.
Measure: Successfully report to CMS (or States) ambulatory clinical quality measures selected by CMS in the manner specified by CMS (or States).

[11] Objective: Implement one clinical decision support rule relevant to specialty or high clinical priority along with the ability to track compliance with that rule.
Measure: Implement one clinical decision support rule.

[12] Objective: Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, and allergies) upon request.
Measure: More than 50% of all patients who request an electronic copy of their health information are provided it within three business days. (Exclusion: Any EP that has no requests from patients or their agents for an electronic copy of the patient health information during the EHR reporting period.)

[13] Objective: Provide clinical summaries to patients for each office visit.
Measure: Clinical summaries provided to patients for more than 50% of all office visits within three business days. (Exclusion: Any EP who has no office visits during the EHR reporting period)

[14] Objective: 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.
Measure: Performed at least one test of certified EHR technology's capacity to electronically exchange key clinical information.

[15] Objective: Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities.
Measure: Conduct or review a security risk analysis in accordance with the requirements under 45 CFR 164.308 (a)(1) and implement security updates as necessary and correct identified security deficiencies as part of its risk management process.

Menu Set Criteria
Given below is the Menu Set of 10 objectives from which physicians can choose any 5. One of the 5 must be either Objective 9 or 10.

[1] Objective: Implement drug formulary checks.
 Measure: The EP has enabled this functionality and has access to at least one internal or external formulary for the entire EHR reporting period.

[2] Objective: Incorporate clinical lab-test results into EHR as structured data. Measure:  More than 40 percent of all clinical lab tests results ordered by the EP during the EHR reporting period whose results are either in a positive/negative or numerical format are incorporated in certified E HR technology as structured data. (Exclusion: An EP who orders no lab tests whose results are either in a positive/negative or numeric format during the EHR reporting period.

[3] Objective: Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach.
Measure: Generate at least one report listing patients of the EP with a specific condition.

[4] Objective: Send reminders to patients per patient preference for preventive/follow-up care.
Measure: More than 20 percent of all patients 65 years or older or 5 years old or younger were sent an appropriate reminder during the EHR reporting period.  (Exclusion: An EP who has no patients 65 years old or older or 5 years old or younger with records maintained using certified EHR technology.

[5] Objective: Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, and allergies) within 4 business days of the information being available to the EP.
Measure: At least 10 percent of all unique patients seen by the EP are provided timely (available to the patient within four business days of being updated in the certified EHR technology) electronic access to their health information subject to the EP’s discretion to withhold certain information.  (Exclusion: Any EP that neither orders nor creates any of the information listed during the EHR reporting period.)

[6] Objective: Use certified E HR technology to identify patient-specific education resources and provide those resources to the patient if appropriate.
Measure: More than 10 percent of all unique patients seen by the EP are provided patient specific education resources.

[7] Objective: The EP who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation.
Measure: The EP performs medication reconciliation for more than 50 percent of transitions of care in which the patient is transitioned into the care of the EP.  (Exclusion: An EP who was not the recipient of any transitions of care during the E HR reporting period.)

[8] Objective: The EP who transitions his/her patient to another setting of care or provider of care or refers his/her patient to another provider of care should provide summary care record for each transition of care or referral.
Measure:  The EP who transitions or refers his/her patient to another setting of care or provider of care provides a summary of care record for more than 50 percent of transitions of care and referrals.  (Exclusion: An EP who neither transfers a patient to another setting nor refers a patient to another provider during the EHR reporting period.)

[9] Objective: Capability to submit electronic data to immunization registries or immunization information systems and actual submission according to applicable law and practice.
Measure: Performed at least one test of certified EHR technology’s capacity to submit electronic data to immunization registries and follow up submission if the test is successful (unless none of the immunization registries to which the EP submits such information has the capacity to receive the information electronically). (Exclusion: An EP who administers no immunizations during the EHR reporting period or where no immunization registry has the capacity to receive the information electronically.)

[10] Objective: Capability to submit electronic syndromic surveillance data to public health agencies and actual submission according to applicable law and practice.
Measure: Performed at least one test of certified EHR technology’s capacity to provide electronic syndromic surveillance data to public health agencies and follow-up submission if the test is successful (unless none of the public health agencies to which an EP submits such information has the capacity to receive the information electronically). (Exclusion: An EP who does not collect any reportable syndromic information on their patients during the EHR reporting period or does not submit such information to any public health agency that has the capacity to receive the information electronically.

(Source: http://www.osteopathic.org/inside-aoa/advocacy/regulatory-issues/Documents/meaningful-use-objectives.pdf)

References:

http://missourihealthconnect.org/FAQRetrieve.aspx?ID=45267

http://www.osteopathic.org/inside-aoa/advocacy/regulatory-issues/Documents/meaningful-use-objectives.pdf

http://www.emrandehr.com/2010/08/30/meaningful-use-resource/

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How Does Email Help You As A Doctor?

Email or electronic mailing has revolutionized business communication. The incentivization of technology in the healthcare industry coupled with its growing inclination towards consumerism and strong patient-doctor relationships has made it necessary for doctors and healthcare professionals to utilize this channel of communication to improve the quality and reach of their practice. However, even though a majority of doctors do own personal email accounts, not many are comfortable using the email for regular, professional correspondence.

Why Should Doctors Use Email?

Doctors are busy people. Email is fast, easy to manage and allows for instant response. As emails can be read on PCs, tablets, smartphones and practically any device with web access in your clinic, home or while commuting, incorporating email communication in your daily practice will help you stay connected with patients and other healthcare professionals wherever you are. 

Email not only improves your accessibility (especially in situations where instant responses are needed for critical correspondence) but also helps you shorten your workday by eliminating those piled up stacks of paper mail that welcome you to your clinic every morning! 

Managing your email is very easy and most free email services are built on simple, user-friendly models. You can send, receive and store all your correspondence instantly, without having to use paper, fax machines or courier services. You can prioritize your mails and respond to them based on the immediacy required. You can use the email to schedule visits, send appointment reminders, prescription refills, lab reports, scans, pre and post surgery care instructions, medication advice and billing details to patients. You can network with media, other doctors and medical professionals in the industry. You can also use it to educate patients by sending useful links and important online study material that could help them understand and work on their condition better.

One of the biggest advantages of using the email is quick and organized storage of all your communication which may include records and other documentation. Your files, scanned paper work, pictures, reports, graphs, numbers and other medical data which have been sent or received via email can be saved and stored online. These files can be neatly organized under appropriate tags for quick and easy retrieval whenever you wish to view them. Adding to that, convenient email search options save you hours of otherwise looking through paper files to find that one elusive paper that just won’t show up!

Using the email to communicate with your patients has a number of advantages. However, you cannot aim to completely replace telephone calls, personal visits and other forms of patient communication with it. One cannot communicate critical medical data requiring the doctor’s personal presence and support using this rather impersonal communication device. Doctors must identify the correspondence that will show positively on productivity and patient satisfaction if exchanged over email and only model those functions and areas under its purview on a regular basis.

Popular Email Services

There are many popular free email services that will help you send, receive, store and manage your correspondence. Gmail, Yahoo, Windows Live and AOL are widely used web email services. MS Outlook or Zimbra can be used to configure your email on your computer and is also a popular choice. Another email service that specifically complies with HIPAA rules is MD email.net (Medical Email). It is a medical industry secure HIPAA email for medical professionals and has over 395,000 doctor-users spanning over 65 medical specialties.

How To Set Up An Email Account?

To set up an email account, key in the URL address of the provider of your choice, click on the usually prominent “Sign up” button, fill a form and you’re ready to get started.

For example, if you wish to set up an account with Gmail, 

1. Goto the URL http://www.gmail.com (You can click this link and it will take you there)

2. Click on “Create an account”

3. Fill in the registration form. 

Here is a video which shows you how.

What’s Keeping the Doctors Away?

The medical industry is historically known to be a conservative one characterized by sluggish and rather cynical adoption of technology. Studies indicate that while 90% patients would like their doctors to be accessible over email, doctors continue to elude this space.

One reason for doctors shying away from using the email could be that email correspondence is not reimbursed by insurance providers. Also, most doctors still prefer to operate under traditional models of communication simply because they have been using them for all these years and are too comfortable to venture out and try newer, faster and more productive ways of reaching out to their patients. 

Security and compliance issues are also responsible for doctors being weary about using email communication in their practice. Medical data is always sensitive and like any other form of communication, email too has its medical-legal implications. The AMA lays down guidelines for doctor-patient electronic communication that can be read at http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/young-physicians-section/advocacy-resources/guidelines-physician-patient-electronic-communications.page

Along with following these guidelines, doctors must ensure that they operate on a secure and reliable internet connection. Computers must be well-protected against spam, virus and other bugs. As a rule of thumb, unknown emails should not be opened. Your password must be unbreachable, kept confidential and regularly changed. Keeping these security guidelines in mind, doctors can safely utilize the benefits of email to improve the productivity and accessibility of their practice.

References:

1. http://www.msnbc.msn.com/id/24260074/ns/health-health_care/t/only-doctors-use-e-mail-patients/

2. http://digital-medicine.blogspot.com/2011/05/doctors-use-of-email-and-social-media.html

3. http://www.in-depthresearch.com/healthcare-it-market-research/why-doctors-dont-use-email/

4. http://mdemail.net/hipaa-medical-email-security/the-news/76-doctors-and-hospitals-use-md-email.html

5. http://www.jmir.org/2006/1/e2/

6. http://office.microsoft.com/en-gb/outlook-help/patients-doctors-and-e-mail-HA001046773.aspx

7. http://www.telegraph.co.uk/health/healthnews/8277674/Patients-could-contact-doctors-by-email.html

8. http://www.advantagesofemail.com/

9. http://www.in-depthresearch.com/healthcare-it-market-research/why-doctors-dont-use-email/

10. http://mdemail.net/hipaa-medical-email-security/the-news/76-doctors-and-hospitals-use-md-email.html

11. http://office.microsoft.com/en-gb/outlook-help/patients-doctors-and-e-mail-HA001046773.aspx

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Why IT Companies Are Important For Doctors?

Healthcare Information Technology (HIT) has the potential to transform global healthcare systems ensuring safer and more effective treatments while increasing the productivity, profitability and efficiency of practices. IT companies have integrated path breaking medical research with ingenious information technology, giving us medical tools, data systems, applications and devices that can change the way healthcare is practiced. Not only has it enabled doctors to connect with patients and other doctors in different parts of the world, HIT makes it possible for them to access a global database of precious medical information. 

Healthcare Information Technology promises to help doctors save money, attend to larger number of patients as well as allow them to implement a patient-centric model of care. The biggest breakthrough that Healthcare IT companies have made so far is the centralization and digitization of patient medical records, popularly known as the Electronic Medical Record or EMR, that has already begun to single handedly revolutionize healthcare as we have known it through the ages.

Benefits of Healthcare IT

 
The adoption of EMRs, contrary to what is popularly perceived, is as beneficial to doctors if not more, as it is to their patients. Since EMRs allow for the creation of one, single interaccesible national medical data system, medical records can be transferred anywhere in the country to help doctors provide effective, accurate and rapid treatment wherever required. So far, with paper based record systems, quick digital record transfers have been impossible, resulting in many unfortunate treatment errors and failures. 

However, IT companies have made it possible for doctors to improve the quality and safety of healthcare with the introduction of the EMR and other such revolutionizing healthcare tools. This has also significantly reduced the enormous assemblage of paperwork that has characterized physician offices and clinics all these years and has given doctors easier and faster access to information. Health insurance policy records and information are also easily retrievable from medical databases, saving practitioners hours of cumbersome and time consuming search work. 

Adoption of HIT has enabled doctors to optimize the cost of treatment and pass the same onto patients due to higher productivity and efficiency levels achieved in their practice. Features such as Computerized Physician Order Entry or CPOE, bar-code scanners and digital decision management systems increase the accuracy levels of administrative processes and treatments by introducing seamless, methodical practice management techniques. 

IT companies have empowered doctors to improve their practice on several fronts like,
 - Patient safety
 - Improved quality of care
 - Error free, accurate treatments
 - Higher doctor and staff productivity
 - Greater and faster access to patient information and medical research
 - Enhanced revenue
 - Lowered costs
 - Paperless offices and clutterfree working conditions
 - Efficient practice management systems

Doctors and Medical Networking
 

The Internet and social networking websites have made it possible for doctors to influence a whole medical community and establish themselves as thought leaders in their field. It has also enabled them to interface with a global clientele through video and web consulting tools, online medical diagnosis, web-based symptom analysis, and other mobile platforms that connect them to patients in remote locations. Doctors can join specialized medical social networks where they can exchange and discuss valuable ideas, diagnoses, complex cases and medical information with other dignitaries in their field. Real time industry news is easily available on such sites and is indispensable for keeping physicians updated and abreast with latest information in a field as dynamic as medicine. These forums not only help practitioners gain relevant and required medical information but also get them noticed and respected by peers and patients alike.

Healthcare IT companies are on their way to building a smarter, centralized and digitally managed healthcare system that will link doctors, patients and policy providers through a single, intelligible medical database. This fusion of medical knowledge and information technology driven by IT companies will not only lend patients a more pleasant and personalized healthcare experience, but will enable doctors to work with greater speeds and accuracy. 

However, for real change to come by, doctors must understand the importance of the game changers that healthcare IT companies are, and work in cooperation with them to contribute to a smart, intelligent and seamless global healthcare system.

References:

http://benefitof.net/benefits-of-technology/
http://www.articlesnatch.com/Article/Advantages-Of-Doctors-Social-Networking/2803300
http://www.buzzle.com/articles/health-information-technology.html

http://technology4doctors.blogspot.com/2011/03/learnings-from-japan-national-health-it.html
http://www.ahrq.gov/downloads/pub/evidence/pdf/hitsyscosts/hitsys.pdf
http://www.digimedhit.com/benefits.asp

http://technology4doctors.blogspot.com/2010/08/improved-patient-safety-using-software.html
http://www.intel.com/Assets/PDF/whitepaper/health-317997001.pdf
http://www.ibm.com/smarterplanet/us/en/healthcare_solutions/article/smarter_healthcare_system.html
http://www.ibm.com/smarterplanet/global/files/us__en_us__healthcare__smarterplanet_healthcare.pdf

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How Much Are The Typical IT Expenses In A Medical Office With EMR?

The introduction of EMR and Meaningful Use incentives has made it necessary for practitioners to undertake effective measures for successful EMR adoption and implementation. In order to maximize returns on EMR and resultant IT investments, physicians must perform a cost-benefit analysis and determine ways in which they can lower costs, save on expenses and utilize IT assets as efficiently as possible. This can be done by charting out a ground plan that underlines all projected expenses and revenue based on realistically researched data and information. 

Budgeting for EMR and IT Expenses

A primary requirement for accurate and realistic budgeting is identifying and understanding various elements that are involved in setting up your EMR and medical IT infrastructure. A good way to do so is by recognizing and incorporating factors that have contributed to successful EMR implementations at other physician practices. An effective EMR and medical IT budget will require you to look at a number of cost factors. Typically, these would include,
 - Hardware, software, networks, servers
 - Internet, wireless
 - Implementation, training
 - Maintenance, Upgrades, Updates, Technical Support
 - Anti-virus and other security systems
 - Emergency breakdowns and recovery
 - Data storage and backup systems
 - Digitization of existing paper files

You will also  need to account for year on year (or month on month) recurring costs and other hidden soft costs like time and money spent on staff training, revenue lost during the adoption process due to readjustment of workflow, resources utilized for internal IT management and so on. Many of these costs are not explicitly spelt out by vendors as they only surface after the installation has been completed. However, they markedly affect your overall profitability and must be carefully accounted and budgeted for.

EMR and Medical IT Infrastructure Costs

The costs of setting up the IT infrastructure for EMR implementations vary from practice to practice and installation to installation. However, to gain a rough idea or a general estimate about how much physicians can expect to spend on some primary variables involved in EMRs and medical IT set ups, we give you a few numbers (naturally, these will vary depending on market and situational factors).

EMR License – Between $1000 - $ 25,000 (depending on whether your system is an entry level EMR or a fully loaded one with advanced features and functionalities)

Hardware – Usually, Tablet PCs are recommended for primary providers and thin clients or workstations are suggested for assistant use. All these are centrally networked via a master server. Tablet PCs may be estimated at $2200, workstations at $1000 each and server at $5000-$10000.  

Implementation Costs – These are usually billed within the range of $90 - $150 per hour. Implementation includes setting up the network, customizing the software to the specifics of your practice as well as staff and employee training. 

In addition, you will need to incorporate projections for broadband connections and other soft costs that are specific to the nature and requirements of your practice.

It is also important to account for returns, benefits and added revenue that will accompany a fully implemented and adopted EMR system. Research by The American Journal of Medicine suggests that physicians can expect to save approximately $29,000 per year starting from their second year of EMR implementation, if the EMR system is used to its maximum potential. 

Another study reveals that EMRs worked to full capacity can increase the number of patients seen by as much as 15%, adding that much more to the physician’s annual revenue.

Optimizing Your Return on EMR Investment

Budgeting can help you draw out a roadmap to minimize unpredictable outflows of cash ensuring a secure financial environment for your practice to function. Even though your budget will focus on minimizing adoption costs and maximizing post-adoption value and returns, in the end, a budget is only as good as the efficiency and method with which it is followed. 

Here are certain guidelines that will help you extract maximum value from your EMR and IT investments.

 - Physicians must look at improving the speed at which the EMR systems are adopted and internalized in the daily workflow of the practice. This will save on a good chunk on staff training and downtime costs.
 - Look at upgrading your existing IT systems wherever possible, instead of replacing them altogether.
 - Try to have your EMR vendor include as much training time as possible, as part of the EMR package.
 - Ask vendors about the payment plans they offer (payment in parts or installments as opposed to complete down payments) and chart out an arrangement that best agrees with your financial interests.
 - Use antivirus software, firewalls and other security systems to prevent unprecedented system breakdowns and crashes.
 - Read all offer documents very carefully and get detailed information and clarifications on terms, products and services mentioned in the contract. Make sure that all verbal agreements are put in writing to avoid post-installation conflicts or confusion.

You can calculate your practice’s return on EMR investment using an ROI calculator similar to the one found at http://www.clinkareonline.com/clinkare-roi-calculator. This ROI calculator bases your return estimates on parameters like size of the medical office, number of providers, strength of staff, patient volumes, fees and so on.

References:

1.    http://www.emrexperts.com/emr-roi/index.php
2.    http://newsroom.cdwg.com/features/feature-12-13-10.html
3.    http://www.orthosupersite.com/view.aspx?rid=24613
4.    http://blog.vcpi.com/2010/11/top-must-haves-in-your-emr-budget-and-ways-to-finance-them/

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What Do Practices Look For When Hiring A Medical Assistant?

Digitization of the healthcare industry has lead to an increasing demand for qualified, experienced and IT educated medical assistants to help practices and physicians meet their Meaningful Use objectives. Although this has opened up many new opportunities for job seeking medical assistants, it has also resulted in practices raising the bar pertaining to candidate quality, experience and training standards.

Jobs and Duties of a Medical Assistant

As a medical assistant, you are in charge of performing administrative and basic clinical tasks of the practice. While your job description may differ depending on the size and location of the practice, your basic responsibility is to ensure the smooth and efficient running of day to day operations and clinical tasks that are assigned to you. The clinical duties that a medical assistant is eligible to discharge vary according to state law. Practices require medical assistants to be well-versed with patient and laboratory work, administrative activities like maintaining medical records, bookkeeping, filing tax returns and insurance forms, hospital admissions, appointment scheduling, patient-practice correspondence, billing and other practice management duties.

Some practices require medical assistants to help physicians with pre and post treatment procedures like recording vital stats (height, weight, blood pressure, temperature), medical histories, drug allergies and routine lab tests. They may also be expected to provide first aid, remove sutures, change bandages, give injections and take X-rays or other scans.

Formal Education, Training and Certification

Although practices impart training on the job, experienced candidates with formal education, certification or a degree are generally preferred. 1 year certificate or diploma programs, or 2 year associate degree programs are offered in vocational-technical high schools.
 
Candidates who have received formal training in medical assisting are well-versed with anatomy, physiology, medical terminology and administrative functions like maintaining records, transcripts, accounts and insurance processing. Clinical and diagnostic procedures, laboratory testing, pharmaceutical proficiency, first aid are also covered in these programs along with office management activities, skills and techniques. As formally trained candidates already have a good command over the duties and functions of medical assisting, they naturally hold the edge over novice medical assistants in job interviews and selection procedures.


Healthcare IT Skills

Practices require medical assistants to look after the front office administration including staff management, appointment scheduling, filing reports, maintaining patient charts, bookkeeping, billing, tax and insurance processes. With the federal government incentivizing Meaningful Use of EMR implementations, a majority of administrative and clinical tasks have been digitized. As the onus of meeting Meaningful Use objectives lies largely with medical assistants, practices have started to consider IT skills as indispensable to medical assistant skill sets and resumes.

Soft Skills

Medical assistants must be equipped with good communication skills. As they are essentially the connecting link between patients and physicians, it is important for medical assistants to develop soft skills that make the patients feel welcome and comfortable in a place they don’t really want to be in. Interacting with patients and their families, providing them all the information they would need in order to ease their apprehensions, displaying empathy and understanding the delicacies of communication in a dispiriting hospital environment, are skills that practices are imploring their medical assistants to imbibe and develop.

Lastly, medical assistants must be capable of handling intense emergency situations placed against chaotic emotions, flying egos and anxieties. It is absolutely essential for them to maintain a calm, patient and positive attitude to focus on keeping their nerves intact and getting the job done.

References:

1. http://medicalassistant-jobs.blogspot.com/2010/03/communication-therapeutic-skills-for.html
2. http://www.ehow.com/about_5341447_general-skills-needed-medical-assistant.html
3. http://technology4doctors.blogspot.com/2011/05/information-technology-orientation-for.html
4. http://www.medicalassistantx.com/expectations-of-behaviour-and-medical-assistant-code-of-ethics/
5. http://www.medicalassistantx.com/know-the-basic-medical-assistant-requirements/
6. http://www.medicalassistantx.com/the-skills-of-the-medical-assistant/
7. http://www.medicalassistantx.com/whatdoesamedicalassistantdo/

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Can FREE EMRs get your practice through Meaningful Use?

With the federal government pushing EMR implementations by incentivizing their Meaningful Use, providers of Healthcare Information Systems are all rushing in to get a bite of that booming business pie. As a result, doctors and practitioners find themselves lost in a sea of information and complicated jargon about the various types of EMRs and EHRs available, each claiming to be the best for your Meaningful Use objectives.

Traditional EMR business-models have priced EMR systems for tens of thousands of dollars, making it prohibitive for practices to adopt them. However, with EMRs now being a statutory requirement, an increasing number of Healthcare IT providers are starting to work on revenue models that enable them to provide practitioners with outstandingly efficient EMR systems, absolutely free of cost.

Advantages of FREE EMRs over Locally-Hosted Priced EMRs

It is easy to assume that a free EMR may be inferior in terms of quality or has limited number of features and will hinder your practice from qualifying for the $44,000 incentive pay. The fact is that most free EMRs are web-based systems built with inherent technological features that not only allow them to be provided for free but also lend them a number of advantages over costly, locally hosted EMR systems.

FREE EMRs Cost Nothing

Being web-based, free EMRs can save you the cost of purchasing, installing and maintaining a private, local server which is a primary requirement for traditional, locally-hosted EMR systems. All you need to have, to get a free EMR up and running is a computer and a secure Internet connection. For smaller practices as well as for practices that lack the capital to invest in client-server systems and additional I.T staff to maintain local EMRs, free, web-based EMRs are an ideal choice. Because they are absolutely free, they carry no out-of-pocket, hidden charges that come to the fore after you have subscribed. With free EMRs, you can direct the $44,000 incentive pay to improve and develop your practice, instead of using it to pay for a local EMR.

Convenient and Easy to Use

Remotely hosted or web-based free EMRs are typically more user-friendly and easy to use as compared to other complicated EMR systems that take months of getting used to. Infact, free EMRs that are available in the market today, take only minutes to activate, saving you from all the lengthy, time-consuming installation processes that accompany local EMRs.

Data Security and Accessibility

Free EMRs, contrary to popular perception, are highly secure and protect your data by functioning under stringent confidentiality protocols. Remote hosting of free EMRs allows data to be accessed from any computer, anywhere, over a secure Internet connection. To add to that, your data is backed up on the remove server, completely discarding the possibility of data loss or system breakdowns. On the other hand, local systems are susceptible to hardware breakdowns, power cuts and system failures that bring your practice to a halt until someone arrives to restore it.

Features Required for Meaningful Use

Most local EMR systems contain a limited set of features that help you meet only a few of the required number of Meaningful Use objectives. You are thus forced to install supplementary systems to fulfil other objectives, amounting to additional cost, time and effort. One of the main reasons why free EMRs are so popular with practitioners today is because most of them are equipped to deal with feature requirements for all of the 20 objectives.


Feedback and Interaction with Users

Many Free EMRs make their money through the ads they place at the bottom of the system page. The success of an ad-based model such as this lies in how well and how much its users are able to employ it. Thus, free EMR providers take continual feedback and suggestions from the user community and incorporate them in the system. Free EMRs keep evolving with newer practices and suggestions, giving you immediate and regular updates of the software without having to install anything locally. On the other hand, local EMRs once sold are rarely updated, with each update requiring the EMR vendor to personally install it.


References:

1.   http://www.revenuexl.com/blog/bid/19051/Top-10-Electronic-Medical-Record-Software-Features-for-every-Physician
2.    http://digital-medicine.posterous.com/what-are-the-advantages-of-using-web-based-em
3.   http://www.binaryspectrum.com/electronicmedicalrecord/which-is-better-web-based-EMR-system-or-client-server-EMR-system.html
4.   http://emrguy.com/what-are-the-advantages-of-using-web-based-emr-software/
5.   http://www.practicefusion.com/pages/free_ehr.html

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America’s Top CCHIT Certified EMR Systems

With an estimated 300-400 companies peddling to sell their EMR systems in the country, medical practitioners find it overwhelmingly difficult to choose an EMR system that is best suited to their practice and specialization. In order to narrow down the multitude of options available in the market today, a good idea would be to start by reviewing America’s top CCHIT Certified EMR systems.

What is CCHIT Certification? Does it guarantee EMR quality and performance?

CCHIT is an independent, non-profit organization that develops criteria for its CCHIT Certified® program based on nationally recognized standards to certify EHRs. These certification criteria are developed by your peers – work groups of practicing clinicians and health information technology experts – taking into account the state of the art of EHRs and your complex needs.

CCHIT has been certifying EHRs since 2006.  For more information, visit http://www.cchit.org

CCHIT Certification is a good initial requirement that can help you limit the range of your search to a realistic number. However, it does not guarantee EMR quality and performance and should not have the final say in your decision. Because an EMR is CCHIT Certified, it does not imply that its features will help you meet Meaningful Use objectives.

Once, you have zeroed in on a list of CCHIT Certified EMR systems with the best reviews and recommendations in the market, it is your prerogative to determine which one of these systems has features that will help your practice function efficiently and meet Meaningful Use objectives.

Features of a good CCHIT Certified EMR System

Besides being CCHIT Certified, a good EMR system must provide you with the following features:

• It must be user-friendly and easy to understand.
• It should be low on maintenance and should be easy to update.
• System updates should be free and regular.
• It must include features that are required to manage workflow and functions specific to your specialization.
• Features must be customizable and easy to use.
• It should have a feedback and interaction channel connecting you to the vendors in case of feature requests, suggestions, complaints and grievances.
• The EMR provider must commit to customer support service, user-guidance and quick response time to complaints. 

CCHIT Certified EMRs – America’s Most Recommended EMR Systems  

SoftwareAdvice puts together a list of top CCHIT Certified EMRs in the country. The most recommended systems on their list are given below:

1. Allscripts EHR
2. ADP AdvancedMD EHR Software
3. eClinicalWorks
4. NueMD Complete
5. Aprima EHR (formerly iMedica)
6. Greenway PrimeSUITE 2011
7. MedLedger
8. CareTracker
9. SuiteMed IMS
10. Intivia’s InSync®

You may also take a look at a host of other EMR systems they recommend for consideration at http://www.softwareadvice.com/medical/cchit-certified-emr-software-comparison/

References:

1.    http://www.encounternotes.com/index.php?/before-getting-emr/cchit-certified-emr-software-worst-nightmare.html
2.    http://wirelysis.blogspot.com/2011/04/want-to-acquire-emr-vendor-look-out-for.html
3.    http://www.revenuexl.com/blog/bid/25572/Selecting-EMR-Software-life-beyond-CCHIT-Certification
4.    http://www.cchit.org/sites/all/files/cchit10Reasons.pdf
5.    http://www.himssanalytics.org/docs/Essentials/5thEditionEssentialsIntroduction.pdf
6.    http://www.articledashboard.net/Article/EMR-Software-Features-to-Look-Out-For/7531
7.    http://www.webpt.com/resources/practices/4-things-look-any-emr-system

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