By Amer Khan (akhan@egisticsinc.com) of eGistics (www.egisticsinc.com)
Effectively managing the payables process is a big job for most companies, but for healthcare organizations, it is a particularly tall order -- and it's about to get a lot more challenging.
The problem in managing healthcare payables stems from the byzantine network of buyer and seller relationships employed by most healthcare organizations, combined with the increasingly complex procurement processes and contracts that healthcare organizations use to purchase goods and services. Every day, the typical healthcare organization receives a mountain of invoices from many different suppliers, most under different contracts with potentially different payment arrangements.
When you mix in the unusually high number of suppliers that most healthcare organizations use -- a hospital might have thousands of suppliers compared to a few dozen for a big law firm -- you can see how the payables process can quickly become complicated. For instance, on a given day, a hospital might receive invoices for everything from Band-Aids to the pricey cardiology equipment it leases.
The healthcare industry's attempts to address the inefficiencies of the payables continuum have delivered mixed results. Several years ago, group purchasing organizations (GPOs) started sprouting up, allowing healthcare organizations to buy a range of goods and services from a single entity, rather than dealing with multiple vendors. While GPOs have enabled their customers to maximize discounts and reduce the number of vendors they do business with, there are still many cases where healthcare providers must source goods and services directly (such as buying from local suppliers), meaning they still must maintain a high number of supplier relationships.
Here's the scary part: the problem is likely to get worse. Every innovation in the healthcare industry -- whether it's new technologies, new devices or new drugs -- may create more suppliers, generating more invoices, contracts, payment arrangements, and, in some cases, acquisition channels. With our nation focusing like never before on innovations in healthcare, providers have no time to waste.
And while healthcare organizations are focusing tremendous amounts of time and resources on "big issues" such as meeting new requirements for electronic health records (EHRs) and ICD-10, driving down the costs associated with payables can deliver significant benefits as well, and in short order.
So, how can healthcare organizations accomplish this?
Since manual processes don't scale, the healthcare industry will need to rethink its approach to payables. The answer starts with eliminating paper at the earliest point possible in the process.
Whether it's converting paper invoices to electronic images, or convincing business partners to provide electronic invoices in the first place, eliminating paper simplifies and automates the payables process. It allows healthcare providers to apply automated rules for processing, and to initiate an electronic payment with detailed remittance information so the supplier can automatically post the receivables. With these types of solutions, providers can solve their current business challenges and lay a solid foundation to manage the increasingly complex payable environment that is sure to come.
What do you think?
Showing posts with label EHR. Show all posts
Showing posts with label EHR. Show all posts
Thursday, September 30, 2010
Wednesday, March 3, 2010
Critical Actions for HIE
By Mark Brousseau
There are five critical actions that healthcare organizations need to take to ensure the success of their information sharing initiatives, Jamie Welch, CIO, Louisiana Rural Health Information Exchange (LARHX) told attendees this morning at HIMSS10 at the Georgia World Congress, in Atlanta.
LARHX’s information sharing initiative includes telemedicine, distance learning, physician learning, physician rotation, patient information sharing, electronic medical records, and mobile mammograms.
These are the five critical actions Welch outlined:
Work at the grassroots level to articulate your business case.
“If you start to boil the ocean before you boil the pond, it’s not going to work,” Welch said. “We know the lingo and we know the vendors – it’s what we do. For the general public, it’s not. The majority of what they hear about health IT is about a Congress that can’t decide if it’s good or bad, and about information breaches.”
“From Day 1, we made sure that everyone understood what the benefits of our project would be over time. We had to convince people that if you let us do this, then these would be the benefits you will see,” Welch said. “Once we got people to see this, then a lot of our challenges solved themselves.”
Link your objectives to measurable outcomes
“You need to present something that is tangible. Everybody likes the cold, hard data, not theoretical information,” Welch said. “We keep track of everything: money saved, days saved, travel time saved, waiting room time saved, duplicate tests saved – you name it.”
Define the governance strategy that works best for your participants
“One model isn’t going to work for everybody,” Welch said.
Mix and match best practices
“We all know what the best practices are. But we can’t all pattern ourselves after each other, because each part of the country is different, and each patient population is different,” Welch said. “Take the best of all worlds and make it work for you.”
Remember that this is not an IT project – it’s a patient project
“Keep patients and physicians involved, and remember it is all about the patient and the physician and better health outcomes,” Welch said. “The health IT element is frosting.”
What do you think?
There are five critical actions that healthcare organizations need to take to ensure the success of their information sharing initiatives, Jamie Welch, CIO, Louisiana Rural Health Information Exchange (LARHX) told attendees this morning at HIMSS10 at the Georgia World Congress, in Atlanta.
LARHX’s information sharing initiative includes telemedicine, distance learning, physician learning, physician rotation, patient information sharing, electronic medical records, and mobile mammograms.
These are the five critical actions Welch outlined:
Work at the grassroots level to articulate your business case.
“If you start to boil the ocean before you boil the pond, it’s not going to work,” Welch said. “We know the lingo and we know the vendors – it’s what we do. For the general public, it’s not. The majority of what they hear about health IT is about a Congress that can’t decide if it’s good or bad, and about information breaches.”
“From Day 1, we made sure that everyone understood what the benefits of our project would be over time. We had to convince people that if you let us do this, then these would be the benefits you will see,” Welch said. “Once we got people to see this, then a lot of our challenges solved themselves.”
Link your objectives to measurable outcomes
“You need to present something that is tangible. Everybody likes the cold, hard data, not theoretical information,” Welch said. “We keep track of everything: money saved, days saved, travel time saved, waiting room time saved, duplicate tests saved – you name it.”
Define the governance strategy that works best for your participants
“One model isn’t going to work for everybody,” Welch said.
Mix and match best practices
“We all know what the best practices are. But we can’t all pattern ourselves after each other, because each part of the country is different, and each patient population is different,” Welch said. “Take the best of all worlds and make it work for you.”
Remember that this is not an IT project – it’s a patient project
“Keep patients and physicians involved, and remember it is all about the patient and the physician and better health outcomes,” Welch said. “The health IT element is frosting.”
What do you think?
Sunday, February 28, 2010
Start ARRA Awareness Training Now
By Mark Brousseau
If they haven’t done so already, companies in the healthcare space should conduct organizational awareness training on ARRA and HITECH, Mary Rita Hyland, AVP, regulatory affairs, The SSI Group, Inc., told attendees at the Medical Banking Project Boot Camp at HIMSS10 this afternoon.
Organizations also should conduct a HIPAA and HITECH gap analysis to identify any products, procedures and services that need to be updated and modified, Hyland told attendees. As part of this exercise, organizations need to identify and coordinate technical or product updates, as well as coordinate and implement policy and procedural updates. “Operationally, ensuring compliance with HITECH’s security and privacy provisions is, to a large degree, an IT function,” Hyland noted.
Once they’ve reviewed their systems, policies and procedures, organizations need to audit and assess their compliance. “You don’t want to wait for an audit to be done on you by a whistleblower or someone else in the industry who doesn’t believe you are in compliance,” Hyland warned. “Audits are going to be important in meeting the guidelines and maintaining your compliance.”
If they haven’t done so already, companies in the healthcare space should conduct organizational awareness training on ARRA and HITECH, Mary Rita Hyland, AVP, regulatory affairs, The SSI Group, Inc., told attendees at the Medical Banking Project Boot Camp at HIMSS10 this afternoon.
Organizations also should conduct a HIPAA and HITECH gap analysis to identify any products, procedures and services that need to be updated and modified, Hyland told attendees. As part of this exercise, organizations need to identify and coordinate technical or product updates, as well as coordinate and implement policy and procedural updates. “Operationally, ensuring compliance with HITECH’s security and privacy provisions is, to a large degree, an IT function,” Hyland noted.
Once they’ve reviewed their systems, policies and procedures, organizations need to audit and assess their compliance. “You don’t want to wait for an audit to be done on you by a whistleblower or someone else in the industry who doesn’t believe you are in compliance,” Hyland warned. “Audits are going to be important in meeting the guidelines and maintaining your compliance.”
Solving the Revenue Cycle
By Mark Brousseau
Banks are well positioned to help “solve” the healthcare revenue cycle, thanks to the keystone revenue cycle data that flows through banks every day, Benchmark Revenue Management CEO Tyson McDowell said at the Medical Banking Project Boot Camp in Atlanta this afternoon.
“Banks can solve operational improvement issues for hospitals, while solving transparency and risk management issues for themselves,” McDowell told attendees. He said banks should “grow-up” their healthcare revenue cycle solutions and extend into denial management, denial avoidance, and services that back up their healthcare customers’ revenue cycle workers with “on-demand” talent.
Today, many banks offer lockbox services, patient payment solutions and extended lockbox services.
“The revenue cycle improvement market is exploding due to permanent financial pressures,” noted McDowell. “While the official definition of the revenue cycle is all of the administrative processes related to collecting all fees owed for services to patients, a more practical definition would be: a near futile attempt to collect all the monies owed in a world with thousands of moving parts.”
“A hospital really has no idea how much money it’s going to get paid,” McDowell said. “Hospitals and, to a lesser extent individual doctors, are getting it from all sides. Healthcare providers need to protect themselves. And denial and payment data is the keystone for solving the revenue cycle.”
Banks have unique access to this information, McDowell said, and they offer value-added services like lockbox. “Banks are in a position to provide new services for healthcare. And it comes from the data. The hospital needs someone to tell them why they need to spend money on an improvement.”
McDowell concluded that banks are starting to move in the direction of new healthcare services.
Banks are well positioned to help “solve” the healthcare revenue cycle, thanks to the keystone revenue cycle data that flows through banks every day, Benchmark Revenue Management CEO Tyson McDowell said at the Medical Banking Project Boot Camp in Atlanta this afternoon.
“Banks can solve operational improvement issues for hospitals, while solving transparency and risk management issues for themselves,” McDowell told attendees. He said banks should “grow-up” their healthcare revenue cycle solutions and extend into denial management, denial avoidance, and services that back up their healthcare customers’ revenue cycle workers with “on-demand” talent.
Today, many banks offer lockbox services, patient payment solutions and extended lockbox services.
“The revenue cycle improvement market is exploding due to permanent financial pressures,” noted McDowell. “While the official definition of the revenue cycle is all of the administrative processes related to collecting all fees owed for services to patients, a more practical definition would be: a near futile attempt to collect all the monies owed in a world with thousands of moving parts.”
“A hospital really has no idea how much money it’s going to get paid,” McDowell said. “Hospitals and, to a lesser extent individual doctors, are getting it from all sides. Healthcare providers need to protect themselves. And denial and payment data is the keystone for solving the revenue cycle.”
Banks have unique access to this information, McDowell said, and they offer value-added services like lockbox. “Banks are in a position to provide new services for healthcare. And it comes from the data. The hospital needs someone to tell them why they need to spend money on an improvement.”
McDowell concluded that banks are starting to move in the direction of new healthcare services.
Saturday, February 27, 2010
News from HIMSS: Saturday
Posted by Mark Brousseau
Some headlines from the HIMSS health IT conference in Atlanta:
iSOFT showcases health IT solutions
iSOFT Group Limited will showcase its suite of solutions that focus on interoperability at the HIMSS health IT conference in Atlanta in the US from March 1-4, 2010.
iSOFT, which last year entered the important US market through its acquisition of Boston-based technology developer BridgeForward Software (re-named iSOFT Integration Systems), will at HIMSS demonstrate its solutions that are designed to address the requirements for ‘Meaningful Use’ under the US Government’s US$34 billion health IT stimulus package.
iSOFT solutions to be showcased at HIMSS include:
Health Information Exchange
iSOFT’s Health Information Exchange (HIE) solution provides healthcare organizations with access to clinical, financial and administrative data from any hospital information system across the organization. iSOFT’s HIE supports clinicians’ decisions at the point of care, reduces preventable errors and duplicative testing, and encourages best-practice medicine.
Health Intelligence
Health Intelligence (HINT) provides healthcare organizations with insights into organizational trends and statistics that supports informed decisions for future planning, the delivery of better-quality care and increased operational performance.
Integration
iSOFT Viaduct addresses the interoperability challenge faced by all organizations by providing a platform that enables software solutions to share information when needed and in the required form, ensuring seamless integration.
Solution Engineering
Health Studio provides a healthcare solution engineering environment to allow organizations to design, create and deploy their own solutions without needing to engage specialist vendors.
Patient Safety
iSOFT Patient Safety provides intelligence on safety and quality problems and best practices, empowering managers to make strategic improvements by providing an interactive evidence base.
Quest Software and HealthCast tout end-to-end clinical desktop and workflow solution
Quest Software, Inc. and HealthCast, Inc. will demonstrate an end-to-end clinical desktop and workflow solution for clinician access to protected healthcare information.
HealthCast’s eXactACCESS single sign-on and clinical workflow solution, coupled with Quest vWorkspace virtual desktop management solution, provides access to critical electronic health, order entry, and clinical documentation systems. As a result, these systems can be centrally managed to reduce costs and security concerns while increasing control of the clinical desktop environment.
“Our goal is to give physicians and clinicians the fast and easy access they need to their patient information while improving data security and reducing IT infrastructure and support costs,” said Simon Pearce, vice president and general manager of desktop virtualization, Quest Software.
vWorkspace and eXactACCESS automate clinician access to and management of virtual desktops and applications by eliminating the need to enter multiple passwords to disparate systems. HealthCast's unique proximity badge functionality automates the login to the virtual desktop and launches a clinician’s primary application based on who they are, and then navigates them to a default location within the application. When the badge is “tapped” again, the clinician’s virtual desktop and applications are disconnected so that clinicians can go to any other workstation in the enterprise, and securely pick up their desktop and applications exactly as they had left them with another “tap” of their badge.
California Health Information Exchange Networks interconnect
The Santa Cruz Health Information Exchange (HIE) is using Axolotl’s Elysium NHIN Gateway to connect to two California HIE networks - EKCITA in Tehachapi, CA and the Long Beach Network for Health in Southern CA, for exchange and sharing of critical clinical information.
This connectivity will be demonstrated at the HIMSS Interoperability Showcase, supported by the California Health and Human Agency (CHHS), the Office of the National Coordinator (ONC) and the Federal Health Architecture (FHA) to illustrate the progress towards health IT interoperability, nationwide.
The Santa Cruz HIE, utilizing Axolotl’s Elysium Exchange solutions, will demonstrate the ability to query from and exchange data with other California HIEs. The demonstration will highlight how clinical data, based on national standards, is integrated into different physician workflows at the point of care - by the local systems that are chosen in each care setting.
“Patient care will be radically improved through this inter-HIE exchange capability,” said Bill Beighe, CIO of Santa Cruz HIE. “This demonstration will show that HIE-to-HIE information exchange is technically feasible and available now.”
The HL7 Continuity of Care Documents (CCD) being exchanged are standard electronic documents that include discrete data elements which can be extracted and incorporated into the receiving systems. Elysium is leveraging components of the IHE IT Infrastructure set of profiles, such as Cross Enterprise Document Sharing (XDS) and Cross Community Access (XCA) to enable the transfer of the clinical data between connected communities. Multiple records will be exchanged to show that the process is general and not a special case.
“Axolotl participated with the Northrop Grumman consortium in the NHIN I project and in July 2009 did a live NHIN demo connecting five HIEs in California. Axolotl’s Elysium Gateway products that enable inter-HIE information exchange are available in our latest production platform and are being implemented. These products connect HIE Networks seamlessly to any other HIE either directly or via the NHIN,” said Anand Shroff, Vice President, Engineering, Axolotl.
Some headlines from the HIMSS health IT conference in Atlanta:
iSOFT showcases health IT solutions
iSOFT Group Limited will showcase its suite of solutions that focus on interoperability at the HIMSS health IT conference in Atlanta in the US from March 1-4, 2010.
iSOFT, which last year entered the important US market through its acquisition of Boston-based technology developer BridgeForward Software (re-named iSOFT Integration Systems), will at HIMSS demonstrate its solutions that are designed to address the requirements for ‘Meaningful Use’ under the US Government’s US$34 billion health IT stimulus package.
iSOFT solutions to be showcased at HIMSS include:
Health Information Exchange
iSOFT’s Health Information Exchange (HIE) solution provides healthcare organizations with access to clinical, financial and administrative data from any hospital information system across the organization. iSOFT’s HIE supports clinicians’ decisions at the point of care, reduces preventable errors and duplicative testing, and encourages best-practice medicine.
Health Intelligence
Health Intelligence (HINT) provides healthcare organizations with insights into organizational trends and statistics that supports informed decisions for future planning, the delivery of better-quality care and increased operational performance.
Integration
iSOFT Viaduct addresses the interoperability challenge faced by all organizations by providing a platform that enables software solutions to share information when needed and in the required form, ensuring seamless integration.
Solution Engineering
Health Studio provides a healthcare solution engineering environment to allow organizations to design, create and deploy their own solutions without needing to engage specialist vendors.
Patient Safety
iSOFT Patient Safety provides intelligence on safety and quality problems and best practices, empowering managers to make strategic improvements by providing an interactive evidence base.
Quest Software and HealthCast tout end-to-end clinical desktop and workflow solution
Quest Software, Inc. and HealthCast, Inc. will demonstrate an end-to-end clinical desktop and workflow solution for clinician access to protected healthcare information.
HealthCast’s eXactACCESS single sign-on and clinical workflow solution, coupled with Quest vWorkspace virtual desktop management solution, provides access to critical electronic health, order entry, and clinical documentation systems. As a result, these systems can be centrally managed to reduce costs and security concerns while increasing control of the clinical desktop environment.
“Our goal is to give physicians and clinicians the fast and easy access they need to their patient information while improving data security and reducing IT infrastructure and support costs,” said Simon Pearce, vice president and general manager of desktop virtualization, Quest Software.
vWorkspace and eXactACCESS automate clinician access to and management of virtual desktops and applications by eliminating the need to enter multiple passwords to disparate systems. HealthCast's unique proximity badge functionality automates the login to the virtual desktop and launches a clinician’s primary application based on who they are, and then navigates them to a default location within the application. When the badge is “tapped” again, the clinician’s virtual desktop and applications are disconnected so that clinicians can go to any other workstation in the enterprise, and securely pick up their desktop and applications exactly as they had left them with another “tap” of their badge.
California Health Information Exchange Networks interconnect
The Santa Cruz Health Information Exchange (HIE) is using Axolotl’s Elysium NHIN Gateway to connect to two California HIE networks - EKCITA in Tehachapi, CA and the Long Beach Network for Health in Southern CA, for exchange and sharing of critical clinical information.
This connectivity will be demonstrated at the HIMSS Interoperability Showcase, supported by the California Health and Human Agency (CHHS), the Office of the National Coordinator (ONC) and the Federal Health Architecture (FHA) to illustrate the progress towards health IT interoperability, nationwide.
The Santa Cruz HIE, utilizing Axolotl’s Elysium Exchange solutions, will demonstrate the ability to query from and exchange data with other California HIEs. The demonstration will highlight how clinical data, based on national standards, is integrated into different physician workflows at the point of care - by the local systems that are chosen in each care setting.
“Patient care will be radically improved through this inter-HIE exchange capability,” said Bill Beighe, CIO of Santa Cruz HIE. “This demonstration will show that HIE-to-HIE information exchange is technically feasible and available now.”
The HL7 Continuity of Care Documents (CCD) being exchanged are standard electronic documents that include discrete data elements which can be extracted and incorporated into the receiving systems. Elysium is leveraging components of the IHE IT Infrastructure set of profiles, such as Cross Enterprise Document Sharing (XDS) and Cross Community Access (XCA) to enable the transfer of the clinical data between connected communities. Multiple records will be exchanged to show that the process is general and not a special case.
“Axolotl participated with the Northrop Grumman consortium in the NHIN I project and in July 2009 did a live NHIN demo connecting five HIEs in California. Axolotl’s Elysium Gateway products that enable inter-HIE information exchange are available in our latest production platform and are being implemented. These products connect HIE Networks seamlessly to any other HIE either directly or via the NHIN,” said Anand Shroff, Vice President, Engineering, Axolotl.
Friday, February 26, 2010
The Other Story at HIMSS
By Mark Brousseau
While Electronic Health Records (EHR) and the impact of the recent definition of the meaningful use requirements will be hot topics at next week's HIMSS Conference in Atlanta, HERAE CEO Jim Ribelin thinks a program underwritten by the new HIMSS Medical Banking Project bears watching.
The project, called Designing the Healthcare Financial Network of the Future, is "right on target," Ribelin says. "The program will assemble key stakeholders to discuss what a strong financial network for healthcare could look like. A future that doesn’t siphon 20 cents of every healthcare dollar spent, and works to advance the balance between responsible financial management and clinical needs of patients," Ribelin says. The program's objective is to determine how the healthcare system can enhance value, reduce costs, and empower the shift from simple disease management to improved health for consumers, while at the same time creating better business models for the healthcare providers.
"EHRs are receiving a lot of attention, but the payment system, where a lot of new processes are in place with standards and systems defined such as bank ACH transactions, HIPAA 835s and ERA files, provides a real opportunity for significant change. A chance to create a network that will reduce costs and create efficiencies without negative impact on patient care,” says Ribelin. “Fix the healthcare payment system, create a strong financial healthcare network and the industry would see a savings of resources without sacrificing quality healthcare.”
What do you think?
While Electronic Health Records (EHR) and the impact of the recent definition of the meaningful use requirements will be hot topics at next week's HIMSS Conference in Atlanta, HERAE CEO Jim Ribelin thinks a program underwritten by the new HIMSS Medical Banking Project bears watching.
The project, called Designing the Healthcare Financial Network of the Future, is "right on target," Ribelin says. "The program will assemble key stakeholders to discuss what a strong financial network for healthcare could look like. A future that doesn’t siphon 20 cents of every healthcare dollar spent, and works to advance the balance between responsible financial management and clinical needs of patients," Ribelin says. The program's objective is to determine how the healthcare system can enhance value, reduce costs, and empower the shift from simple disease management to improved health for consumers, while at the same time creating better business models for the healthcare providers.
"EHRs are receiving a lot of attention, but the payment system, where a lot of new processes are in place with standards and systems defined such as bank ACH transactions, HIPAA 835s and ERA files, provides a real opportunity for significant change. A chance to create a network that will reduce costs and create efficiencies without negative impact on patient care,” says Ribelin. “Fix the healthcare payment system, create a strong financial healthcare network and the industry would see a savings of resources without sacrificing quality healthcare.”
What do you think?
Thursday, May 7, 2009
e-Health Records Incentives
Posted by Mark Brousseau
An interesting article from the Associated Press.
Stimulus gives incentives for e-health records
Tom Breen, Associated Press Writer
On Wednesday May 6, 2009, 6:06 pm EDT
CHARLESTON, W.Va. (AP) -- Health care providers across the country are moving to replace their old paper records with sleek new electronic systems, a process the Obama administration wants to speed along with over $17 billion in stimulus dollars.
That's a tall order for doctors and hospitals, because an estimated 90 percent of health care offices still stack their records in floor-to-ceiling shelves crammed with manila folders.
The administration's goal is to implement systems that allow doctors and nurses instant access to patient records and to avoid harmful errors in prescriptions and medical charts. But some worry the software isn't yet ready to replace the ease of use of paper records, and say the cost of the systems may be too steep.
Dr. Theodore Hole, a family physician in Ventura, Calif., said when he sees patients who have electronic records from other physicians, they're often a collection of checked boxes and fill-in blanks that are meaningless to doctors outside of the group using the system.
"I'm afraid of the way the technology is being forced on physicians before it's really ready," he said, adding that family physicians have a hard time with the prospect of spending tens of thousands of dollars to install the systems.
Health care providers such as doctors and hospitals would be reimbursed by higher Medicare and Medicaid payments if they put the systems in place by 2011. Doctors can receive up to $60,000 and hospitals up to $11 million. If they don't switch, they could see their Medicare and Medicaid dollars decline.
The health care industry has been moving toward electronic records for years, but the rate of adoption has been slow. Some providers are intimidated by startup costs, which can range anywhere from tens of thousands of dollars for a doctor's office to $100 million for a large hospital.
"It's not going to be enough to pay for it; it's going to be enough to make you want to engage with it," Sentara Healthcare Chief Information Officer Bert Reese said of the stimulus incentives.
The southeastern Virginia network of seven hospitals and hundreds of doctors is in the midst of a decade-long, $237 million conversion project, with all hospitals scheduled to be on board next year. The stimulus plan could mean as much as $40 million to the network, he said.
Though the systems vary, advocates say computerized records are safer and more efficient.
There are fewer mistakes that come from trying to read handwriting, and anyone in a medical system can access the information. When a patient comes into the hospital complaining of chest pains, for example, emergency room staffers don't have to hunt down past medical records for allergies, medications and other information because it's immediately available on a computer screen.
The idea is also to shorten the time involved in basic procedures. Under a paper system, Sentara's Reese said, a doctor entering a medication order for a hospital patient can expect to wait up to an hour before the first dose is administered. With electronic records zapping the order directly from the doctor to the hospital pharmacy, Reese said, it can take about five minutes.
The Obama administration believes converting to electronic medical records will improve patient safety and overall health as well as bring down costs across the spectrum from public to private care, according to the DHHS.
"It's an excellent use of the stimulus money," said Dr. Margaret Staggers, a Fayetteville physician who, as a member of West Virginia's House of Delegates, will help determine how the plan shapes the state budget. All seven of West Virginia's state-owned hospitals have the system in place. "Doctors are interested in getting these systems, but there's so much upfront cost."
Trinitas Hospital in Elizabeth, N.J., estimates it can get $11 million in stimulus funds for its $30 million electronic health records system, according to Ken Raske, president of the Greater New York Hospital Association, which represents about 300 hospitals in the Northeast.
"It's not a bad down payment, but it gives you an idea of the proportion that comes from the stimulus package as opposed to the money they need to invest," he said.
Still, conversion could be slow. An April article in The New England Journal of Medicine concluded there are no reliable estimates on how many hospitals have electronic records, mainly because providers have implemented systems with a piecemeal approach. But it estimates roughly 7.6 percent have at least a "basic" system. For physician practices, the figure is probably around 4 percent.
There are also questions about ease of use, maintenance, compatibility with other systems and keeping all that data secure. Perhaps most urgently, no one yet knows what systems will qualify for reimbursements and keep providers from seeing reduced Medicare and Medicaid payments.
Because of the uncertainty, it's too soon to tell whether the stimulus plan is getting more providers to make the switch, said John Morrissey, spokesman for the Certification Commission for Healthcare Information Technology.
"With so many unanswered questions, it's kind of ludicrous to go too far into it," said Joe Letnaunchyn, president of the West Virginia Hospital Association. "You run the risk of spending money inappropriately."
An interesting article from the Associated Press.
Stimulus gives incentives for e-health records
Tom Breen, Associated Press Writer
On Wednesday May 6, 2009, 6:06 pm EDT
CHARLESTON, W.Va. (AP) -- Health care providers across the country are moving to replace their old paper records with sleek new electronic systems, a process the Obama administration wants to speed along with over $17 billion in stimulus dollars.
That's a tall order for doctors and hospitals, because an estimated 90 percent of health care offices still stack their records in floor-to-ceiling shelves crammed with manila folders.
The administration's goal is to implement systems that allow doctors and nurses instant access to patient records and to avoid harmful errors in prescriptions and medical charts. But some worry the software isn't yet ready to replace the ease of use of paper records, and say the cost of the systems may be too steep.
Dr. Theodore Hole, a family physician in Ventura, Calif., said when he sees patients who have electronic records from other physicians, they're often a collection of checked boxes and fill-in blanks that are meaningless to doctors outside of the group using the system.
"I'm afraid of the way the technology is being forced on physicians before it's really ready," he said, adding that family physicians have a hard time with the prospect of spending tens of thousands of dollars to install the systems.
Health care providers such as doctors and hospitals would be reimbursed by higher Medicare and Medicaid payments if they put the systems in place by 2011. Doctors can receive up to $60,000 and hospitals up to $11 million. If they don't switch, they could see their Medicare and Medicaid dollars decline.
The health care industry has been moving toward electronic records for years, but the rate of adoption has been slow. Some providers are intimidated by startup costs, which can range anywhere from tens of thousands of dollars for a doctor's office to $100 million for a large hospital.
"It's not going to be enough to pay for it; it's going to be enough to make you want to engage with it," Sentara Healthcare Chief Information Officer Bert Reese said of the stimulus incentives.
The southeastern Virginia network of seven hospitals and hundreds of doctors is in the midst of a decade-long, $237 million conversion project, with all hospitals scheduled to be on board next year. The stimulus plan could mean as much as $40 million to the network, he said.
Though the systems vary, advocates say computerized records are safer and more efficient.
There are fewer mistakes that come from trying to read handwriting, and anyone in a medical system can access the information. When a patient comes into the hospital complaining of chest pains, for example, emergency room staffers don't have to hunt down past medical records for allergies, medications and other information because it's immediately available on a computer screen.
The idea is also to shorten the time involved in basic procedures. Under a paper system, Sentara's Reese said, a doctor entering a medication order for a hospital patient can expect to wait up to an hour before the first dose is administered. With electronic records zapping the order directly from the doctor to the hospital pharmacy, Reese said, it can take about five minutes.
The Obama administration believes converting to electronic medical records will improve patient safety and overall health as well as bring down costs across the spectrum from public to private care, according to the DHHS.
"It's an excellent use of the stimulus money," said Dr. Margaret Staggers, a Fayetteville physician who, as a member of West Virginia's House of Delegates, will help determine how the plan shapes the state budget. All seven of West Virginia's state-owned hospitals have the system in place. "Doctors are interested in getting these systems, but there's so much upfront cost."
Trinitas Hospital in Elizabeth, N.J., estimates it can get $11 million in stimulus funds for its $30 million electronic health records system, according to Ken Raske, president of the Greater New York Hospital Association, which represents about 300 hospitals in the Northeast.
"It's not a bad down payment, but it gives you an idea of the proportion that comes from the stimulus package as opposed to the money they need to invest," he said.
Still, conversion could be slow. An April article in The New England Journal of Medicine concluded there are no reliable estimates on how many hospitals have electronic records, mainly because providers have implemented systems with a piecemeal approach. But it estimates roughly 7.6 percent have at least a "basic" system. For physician practices, the figure is probably around 4 percent.
There are also questions about ease of use, maintenance, compatibility with other systems and keeping all that data secure. Perhaps most urgently, no one yet knows what systems will qualify for reimbursements and keep providers from seeing reduced Medicare and Medicaid payments.
Because of the uncertainty, it's too soon to tell whether the stimulus plan is getting more providers to make the switch, said John Morrissey, spokesman for the Certification Commission for Healthcare Information Technology.
"With so many unanswered questions, it's kind of ludicrous to go too far into it," said Joe Letnaunchyn, president of the West Virginia Hospital Association. "You run the risk of spending money inappropriately."
Friday, June 20, 2008
Weak EHR Adoption Called Troubling and Sobbering
Posted by Mark Brousseau
An interesting article from Government Health IT on the slow adoption of electronic health records (EHRs):
4 percent of U.S. doctors use EHRs, new study finds
Nancy Ferris
A milestone study of the adoption of health information technology has produced findings that one of the study’s authors calls troubling and the other calls very sobering.
The survey of 2,758 U.S. doctors, sponsored by the Office of the National Coordinator for Health IT (ONC), found that only 4 percent had a fully functional electronic health record system. Another 13 percent had a basic or partially functional EHR system.
A 2006 study, also sponsored by ONC, found that as many as 9 percent of doctors had fully functional EHR systems. However, Dr. Karen Bell, director of ONC’s Office of Health IT Adoption, said the survey parameters were different.
“There is an increase,” Bell said at a press conference to discuss the results, which were reported in an online edition of the New England Journal of Medicine.
The earlier survey, undertaken by the same team, found that 24 percent of doctors had some sort of computerized record system, but the question allowed them to count billing systems and other kinds of systems not directly related to health care.
Dr. David Blumenthal, director of the Institute of Health Policy at Massachusetts General Hospital and a co-author of the study, said, “We need to get moving a lot faster than we have been if we are going to take full advantage of this technology and realize its promise for medicine."
His colleague, Massachusetts General researcher Catherine DesRoches, said she found reason for hope in the findings. Forty-two percent of the doctors surveyed said their practice had bought an EHR system but had not yet implemented it or they were planning to buy one in the next two years.
“Physicians who use these systems like them,” she said, and they reported that the technology supported better patient care.
But, DesRoches said, doctors are uncertain whether they will get a financial return on their investment in EHRs, and they are fearful of new legal liabilities that could arise. Cost, she said, is the No. 1 barrier to doctors’ adoption of the technology.
Although ONC had touted the previous survey as a benchmark from which to measure future EHR adoption, Bell said the more recent one is “a true benchmark.” She said an agency of the Centers for Disease Control and Prevention will repeat the survey using the same survey instrument in the future.
An interesting article from Government Health IT on the slow adoption of electronic health records (EHRs):
4 percent of U.S. doctors use EHRs, new study finds
Nancy Ferris
A milestone study of the adoption of health information technology has produced findings that one of the study’s authors calls troubling and the other calls very sobering.
The survey of 2,758 U.S. doctors, sponsored by the Office of the National Coordinator for Health IT (ONC), found that only 4 percent had a fully functional electronic health record system. Another 13 percent had a basic or partially functional EHR system.
A 2006 study, also sponsored by ONC, found that as many as 9 percent of doctors had fully functional EHR systems. However, Dr. Karen Bell, director of ONC’s Office of Health IT Adoption, said the survey parameters were different.
“There is an increase,” Bell said at a press conference to discuss the results, which were reported in an online edition of the New England Journal of Medicine.
The earlier survey, undertaken by the same team, found that 24 percent of doctors had some sort of computerized record system, but the question allowed them to count billing systems and other kinds of systems not directly related to health care.
Dr. David Blumenthal, director of the Institute of Health Policy at Massachusetts General Hospital and a co-author of the study, said, “We need to get moving a lot faster than we have been if we are going to take full advantage of this technology and realize its promise for medicine."
His colleague, Massachusetts General researcher Catherine DesRoches, said she found reason for hope in the findings. Forty-two percent of the doctors surveyed said their practice had bought an EHR system but had not yet implemented it or they were planning to buy one in the next two years.
“Physicians who use these systems like them,” she said, and they reported that the technology supported better patient care.
But, DesRoches said, doctors are uncertain whether they will get a financial return on their investment in EHRs, and they are fearful of new legal liabilities that could arise. Cost, she said, is the No. 1 barrier to doctors’ adoption of the technology.
Although ONC had touted the previous survey as a benchmark from which to measure future EHR adoption, Bell said the more recent one is “a true benchmark.” She said an agency of the Centers for Disease Control and Prevention will repeat the survey using the same survey instrument in the future.
Wednesday, June 11, 2008
EHRs Go Beyond Treatment
Posted by Mark Brousseau
An interesting article from Government Health IT on electronic health records:
EHRs go beyond treatment
Health IT promises to streamline agency requests for copies of clients’ medical records
BY Nancy Ferris Published on June 9, 2008
Americans are often asked to supply medical records when they enroll at a school, seek to obtain disability benefits or apply for certain jobs.
Having those records available electronically would make it easier for patients to access them, as long as there is a process in place for authorizing their release from various health care providers’ systems.
The Social Security Administration is leading a project to automate the process for obtaining authorized information from electronic health records. As officials struggle to deal with a growing workload of applications for disability benefits, they say they hope the initiative will make the agency’s job easier and improve service to the public.
SSA receives more than 2 million claims for disability benefits each year, a number that is expected to grow steadily. In each case, the agency obtains names and addresses of the applicant’s doctors and his or her authorization for the providers to release medical records to SSA. The agency then contacts the doctors and waits for the records to arrive by mail — a process that can take months and costs more than $500 million a year.
SSA officials say they envision being able to use the Nationwide Health Information Network (NHIN) to send authorizations to providers electronically and automatically receive the records in return. They are launching a pilot project that involves Beth Israel Deaconess Medical Center in Boston, and they are participating in trial implementations of the NHIN this year.
Not coincidentally, Dr. John Halamka, chairman of the Healthcare Information Technology Standards Panel and a prominent health IT advocate, is Beth Israel Deaconess Medical Center’s chief information officer.
As part of the project, officials will identify HITSP-approved standards that could be used in the process of obtaining medical records, said Debbie Somers, senior adviser at SSA’s Office of Disability Systems.
The agency’s officials know the standards will not completely meet their needs, Somers said, but they are determined to use them whenever possible. They are especially interested in adopting the Continuity of Care Document (CCD) standard, which summarizes the patient’s health conditions, medications and allergies.
At the same time, SSA officials will choose a standard format for electronic medical records used by disability examiners, who spend hours searching through files for specific pieces of information.
“With every hospital and doctor, the record is in a different order and it looks different,” Somers said. With CCD, examiners could pull data into SSA’s system. To make it even easier for them, the agency will highlight certain diagnoses and procedure codes that amount to evidence of disability.
“By the end of August or September, we will actually be requesting real data from [Beth Israel Deaconess] and receiving real live data back, which we can use to [fold] into the medical record,” Somers said.
For the NHIN trial implementations, SSA will work with other project participants to test the system’s ability to send requests and receive electronic medical records from the Military Health System, Veterans Health Administration, Indian Health Service and other providers.
“We hope to still have the same back end on our side but to be able to use the NHIN as a transport,” Somers said.
“It’s really amazing what these first steps are accomplishing,” she said, adding that SSA is on track to have a production infrastructure for retrieving EMRs in place next year.
As a result of the project, SSA could free millions of dollars, people with disabilities could get their benefits faster, and health care providers could be free of dealing manually with records requests from SSA. Halamka has said the resulting cost savings could pay for implementing the technology at hospitals.
Other providers of disability benefits, such as insurance companies, could also find the technology beneficial — along with schools, camps and other organizations that need copies of medical records.
“We may be the largest medical record requester, but we are only one,” Somers said. “People need to be able to provide the authorization and have their medical record go wherever it needs to go.”
An interesting article from Government Health IT on electronic health records:
EHRs go beyond treatment
Health IT promises to streamline agency requests for copies of clients’ medical records
BY Nancy Ferris Published on June 9, 2008
Americans are often asked to supply medical records when they enroll at a school, seek to obtain disability benefits or apply for certain jobs.
Having those records available electronically would make it easier for patients to access them, as long as there is a process in place for authorizing their release from various health care providers’ systems.
The Social Security Administration is leading a project to automate the process for obtaining authorized information from electronic health records. As officials struggle to deal with a growing workload of applications for disability benefits, they say they hope the initiative will make the agency’s job easier and improve service to the public.
SSA receives more than 2 million claims for disability benefits each year, a number that is expected to grow steadily. In each case, the agency obtains names and addresses of the applicant’s doctors and his or her authorization for the providers to release medical records to SSA. The agency then contacts the doctors and waits for the records to arrive by mail — a process that can take months and costs more than $500 million a year.
SSA officials say they envision being able to use the Nationwide Health Information Network (NHIN) to send authorizations to providers electronically and automatically receive the records in return. They are launching a pilot project that involves Beth Israel Deaconess Medical Center in Boston, and they are participating in trial implementations of the NHIN this year.
Not coincidentally, Dr. John Halamka, chairman of the Healthcare Information Technology Standards Panel and a prominent health IT advocate, is Beth Israel Deaconess Medical Center’s chief information officer.
As part of the project, officials will identify HITSP-approved standards that could be used in the process of obtaining medical records, said Debbie Somers, senior adviser at SSA’s Office of Disability Systems.
The agency’s officials know the standards will not completely meet their needs, Somers said, but they are determined to use them whenever possible. They are especially interested in adopting the Continuity of Care Document (CCD) standard, which summarizes the patient’s health conditions, medications and allergies.
At the same time, SSA officials will choose a standard format for electronic medical records used by disability examiners, who spend hours searching through files for specific pieces of information.
“With every hospital and doctor, the record is in a different order and it looks different,” Somers said. With CCD, examiners could pull data into SSA’s system. To make it even easier for them, the agency will highlight certain diagnoses and procedure codes that amount to evidence of disability.
“By the end of August or September, we will actually be requesting real data from [Beth Israel Deaconess] and receiving real live data back, which we can use to [fold] into the medical record,” Somers said.
For the NHIN trial implementations, SSA will work with other project participants to test the system’s ability to send requests and receive electronic medical records from the Military Health System, Veterans Health Administration, Indian Health Service and other providers.
“We hope to still have the same back end on our side but to be able to use the NHIN as a transport,” Somers said.
“It’s really amazing what these first steps are accomplishing,” she said, adding that SSA is on track to have a production infrastructure for retrieving EMRs in place next year.
As a result of the project, SSA could free millions of dollars, people with disabilities could get their benefits faster, and health care providers could be free of dealing manually with records requests from SSA. Halamka has said the resulting cost savings could pay for implementing the technology at hospitals.
Other providers of disability benefits, such as insurance companies, could also find the technology beneficial — along with schools, camps and other organizations that need copies of medical records.
“We may be the largest medical record requester, but we are only one,” Somers said. “People need to be able to provide the authorization and have their medical record go wherever it needs to go.”
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