Meaningful Use, the Technology, the User or the Policy?

The gloves are off and many are now shouting their distain for Meaningful Use from rooftops. Like many before it, the policy was bred out of hope for positive change in U.S. healthcare system, but has it done more bad than good?  30 billion dollars devoted to creating healthcare IT standards and computerizing healthcare organizations in an attempt to forge the digital pathway for the American healthcare system and to what avail, many are asking? I think the bigger question is why is it so difficult for this industry to go digital, why is it even a debate, every other industry is digital so why then, is taking our #1 Gross National Product and making it accountable to the digital standards of other industries so difficult?

Many want to go back to the beginning, to review the history of federal IT policy, some want to blame the vendors who create the EHR software and it’s inefficiencies, while others are content to point out that in order to make a technology successful you must first utilize it in the intended way, pointing their set of fingers at healthcare providers who implement technology but do not utilize it meaningfully.

Two recently published articles, “EHRs continue to be a challenge to HHS, published by, Healthcare IT News, and Meaningful use: Born: 2009—died 2014?, published by, Wachter’s World, address the above mentioned issues, however not in their entirety. This is not an easy battle to win but it is a fight worth having, none of these challenges are singularly to blame, but each are responsible in part to hindering the intended goal of transitioning a historically paper world of healthcare to the digital age. The best approach to reaching this common goal is to elicit consultants who have successfully obtained this feat and make it their mission to implement best practices. In the words of Heraclitus, “Big results require big ambitions.”

Contact EHR & Practice Management Consultants, Inc. (www.ehrpmc.com) at 1-800-376-0212 or contact@ehrpmc.com for help in optimizing your EHR system by having our experienced consultants provide best practices on usage for your particular EHR system.

OIG: Paying Close Attention To HIPAA Security In Meaningful Use Audits

According to the recently released work plan of The Office of the Inspector General will continue to pay closer attention to the healthcare industry’s use of electronic health records – in particular HIPAA security, EHR incentive payments and fraud.

As digitization continues to be a priority so does it’s appropriate implementation and use. In a response to ensure IT security, compliance and electronic health records, the OIG has requested a $400 million FY2015 budget, an increase of $105 million and creating another 284 fulltime jobs to enforce the OIGs audits and reviews.

“Important changes are taking place across the healthcare industry,” wrote Daniel R. Levinson, U.S. inspector general, in OIG’s 2015 work plan justification. These changes, Levinson continued, include “an emphasis on coordinated care and an increased use of electronic health records. OIG will need to adopt oversight approaches that are suited to an increasingly sophisticated healthcare system and that are tailored to protect programs and patients from existing and new vulnerabilities.”

So how does that translate to healthcare providers and healthcare organizations? Practices can expect closer scrutiny for HIPAA privacy and security compliance. Penalties have increased significantly under the new regulations. Practices can face fines up to $50,000 per occurrence—quickly offsetting or negating the EHR incentives they received.

Physicians can no longer afford to be relaxed about HIPAA compliance. They must have sound privacy and security protocols in place to protect against violations that could result in severe penalties.

A prime example occurred in July 2009, when a physician and two former employees of an Arkansas medical center pleaded guilty to misdemeanor federal charges that they inappropriately accessed the medical records of a local television anchor, thereby violating the HIPAA privacy rule. Each faces a maximum penalty of one year in prison, a fine of up to $50,000, or both.

EHR Data Continues To Save Lives

In the midst of all the MU Stage 2 controversy comes evidence that EHRs are still having positive impacts on patient health outcomes. In May of this year Healthcare It News released an article with data provided by the Department of Health and Human Services, reported 15,000 lives and $4B saved so far from HAC reductions.

These reductions in adverse drug events, falls and infections have prevented nearly 15,000 deaths, avoided 560,000 injuries and saved as much as $4 billion in health spending over the same period.

“We applaud the nationwide network of hospital systems and providers that are working together to save lives and reduce costs,” said outgoing HHS Secretary Kathleen Sebelius. “We are seeing a simultaneous reduction in hospital readmissions and injuries, giving patients confidence that they are receiving the best possible care and lowering their risk of having to be readmitted to the hospital after they get the care they need.”

A more recent study by researchers in the U.S. and United Kingdom published by CMAJ Open analyzed 11.5 million electronic patient records, identifying a jaw dropping number of undiagnosed cases of diabetes. Using an algorithm that analyzed biomedical data, researchers were able to identify that off the total 1,174,018 patients with diabetes, 63, 620, had undiagnosed diabetes. Diabetes kills one person every six seconds and afflicts 382 million people worldwide, according to the International Diabetes Federation, a staggering number indeed. If the only positive outcome of EHRs were to identify diabetes patients worldwide and in return provide the treatment they require in order to save their life, it would be worthwhile. Suffice being inundated with negative commentary on EHRs and Meaningful use in the last few months, I believe this is enough evidence to at least quiet the cynics and chalk this one in the win category.

If you need assistance with optimizing your EHR or andy other EHR needs please contact EHR & Practice Management Consultants, Inc (www.ehrpmc.com) for additional assistance at 1-800-376-0212 or contact@ehrpmc.com

Former Hospital CFO Charged with Healthcare Fraud by Falsely Attesting for Meaningful Use Incentives

Eligible Professionals (EPs) and Eligible Hospitals (EHs) could easily lead to errors in meaningful use (MU) attestations. If audited these errors would turn up based on pre- and post-payment attestations and separate the knowledge gaps from willful actions.

As for looking at this case a grand jury indictment is not evidence of guilt, and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.” For the details of the indictment we have the FBI to thank:

“Joe White, 66, of Cameron, Texas, was indicted by a federal grand jury on January 22, 2014, and charged with making false statements to the Centers for Medicare and Medicaid Services (CMS) and aggravated identity theft.”

“According to the indictment, on November 20, 2012, White falsely attested to CMS that Shelby Regional Medical Center (Shelby Regional) met the meaningful use requirements for the 2012 fiscal year. However, Shelby Regional relied on paper records throughout the fiscal year and only minimally used electronic health records. To give the false appearance that the hospital was actually using Certified Electronic Health Record Technology, White directed its software vendor and hospital employees to manually input data from paper records into the electronic health record (EHR) software, often months after the patient was discharged and after the end of the fiscal year.”

“The indictment further alleges that White falsely attested to the hospital’s meaningful use by using another person’s name and information without that individual’s consent or authorization. As a result of the false attestation, CMS paid Shelby Regional $785,655. In total, hospitals operated by Dr. Mahmood, including Shelby Regional, were paid $16,794,462.66 by the Medicaid and Medicare EHR incentive programs for fiscal years 2011 and 2012.”

“If convicted, White faces up to five years in federal prison for making a false statement and up to two years in federal prison for aggravated identity theft.”

As more and more federal stimulus money is made available to providers to adopt Electronic Health Record systems and meaningfully use them our firm is expecting to see many more cases like this case.

If you need help with a Meaningful Use Audit, Meaningful Use Appeal,  Mock Audit or Have Questions on Attesting for Meaningful Use we would be happy to help you to avoid these pitfalls.  Feel free to contact Vanessa Bisceglie MBA, B.S. with EHR & Practice Management Consultants, Inc.  at 800-376-0212 or email her at vanessa.bisceglie@ehrpmc.com.

For 2014 eRX Events You No Longer Need to Report G-codes (G8553)

Did you know that 2013 was the final program year for participating and reporting in the Medicare Electronic Prescribing (eRx) Incentive Program?

The 6-month 2014 eRx payment adjustment reporting period, which began on January 1, 2013 and ended on June 30, 2013, was the final reporting period to avoid the 2014 eRx payment adjustment. You do not need to report G-codes (G8553) for 2014 eRx events.

Patients Who Actively Engage With Patient Portals Have Better Outcomes and Lower Costs to Care

If improving patients’ health matters, and your organization’s bottom line is top of mind, then the notion of patient engagement should catch your attention.

It’s a hot topic in today’s world, as more and more clinical evidence underscoring the benefits of patient engagement catches the industry spotlight.

Chanin Wendling from Geisinger Health System said the numbers do the talking when they conducted by research at the University of Oregon.  They examined health engagement data on approximately 30,000 patients across 40 Minnesota-based primary care clinics. At the conclusion of their research they found patients that had the lowest patient engagement levels cost from 8% to 21% more than the patients who were actively engaged in their health.

“I can sit with a patient as a provider and tell them they need to stop smoking and that all of their health issues stem from the fact that they’re smoking, but I can’t actually stop the smoking for the patients themselves,” said Wendling. “I can get them counseling; I can send them to the appropriate resources, but the patient actually has to take steps themselves to be involved in their healthcare.”

Geisinger health system utilized text messaging, portals, iPads and touch screens to connect patients to their care.

“Unfortunately, providers have very little time with patients,” added Wendling. So, “if you can get the patient to be actively involved in managing their conditions, life is better both from the patient health outcomes perspective as well as the cost to the system.”

For more information on selecting and implementing a patient portal in your medical office (practice) or hospital please contact Vanessa Bisceglie M.B.A., B.S. at EHR & Practice Management Consultants, Inc. www.ehrpmc.com 847-322-0139 or vanessa.bisceglie@ehrpmc.com

Medicare Meaningful Use EP Attestation Extended until March 31st at 11:59 pm EST

The Centers for Medicare and Medicaid Services has extended the deadline for EP attestation to March 31 at 11:59 pm EST.

CMS is offering assistance to hopsitals having difficulty submitting their attestations, enabling them to submit retroactively and avoid the 2015 payment adjustment. Hospitals are to contact CMS, at EH2013Extension@Provider-Resources.com, by March 15 for assistance in submitting retroactively.

The extension does not cover the PQRS  or the Medicaid Meaningful Use Program.

If you have any questions regarding attesting in 2013 feel free to contact me and our team will be happy to help you attest!

Vanessa Bisceglie M.B.A, B.S.,  President,  EHR & Practice Management Consultants, Inc.   www.ehrpmc.com  800-376-0212  847-322-0139

Important Items You Need To Know In 2014 If You Are Eligible To Participate in the Meaningful Use Incentive Programs:

Important Items You Need To Know In 2014 If You Are Eligible To Participate in the Meaningful Use Incentive Programs:

1.  You need to upgrade to the 2014 Edition Certified EHR software.

2.  Make sure your EHR vendor will meet the 2014 certification criteria.

3.  In 2014 a special change has been made, only an EP can attest for any 90 day continuous period, regardless, if you have attested in the past to accommodate providers whose EHRs are not yet 2014 certified. EPs last date of the reporting period is October 1, 2014 to attest for 2014.

4.  For providers participating in the Medicare EHR Incentive Program 2014 is the last year to participate in the Medicare EHR Incentive Program

5.  If you do not attest by 2014 for Meaningful Use you will receive a payment adjustment to Medicare reimbursements starting January 1, 2015.  The penalty is 1% the first year and will go up incrementally each year to a maximum of 5%.

  • A provider can register for the Meaningful Use program in 2015 but they will not receive an incentive payment.
  • If 2014 is your first year to attest you can still qualify for $24,000 in incentive payments over a 3 year period.
  • Meaningful Use Stage 1 Objectives will change in 2014.  Please see the tipsheet from CMS
Meaningful Use Attestation Clinical Quality Measure
 Requirements Requirements
EPs EH/ CAHs EPs EH/ CAHs
Core Menu Core Menu
2011 Stage 1 15 5 out of 10 14 5 out of 10 Report on 6 Report on 15
2014 Stage 1 13 5 out of 9 11 5 out of 10 Report on 16 that cover at least 3 out of 6 National Quality Strategy Domains Report on 16 that cover at least 3 out of 6 National Quality Strategy Domains

7. Meaningful Use Audits are to be conducted for both pre-payment and post-payment in up to 10% EPs audited each year.6. EPs can no longer claim an exclusion on a menu objective if there are other menu objectives they can meet.

8. Stage 2 will be extended through 2016 and Stage 3 will begin in 2017 for those providers who have completed at least 2 years in Stage 2.  Therefore, a provider could potentially attest in Stage 2 for 3 years instead of 2 years.

STAGES OF MEANINGFUL USE
1st YEAR

2011

2012

2013

2014

2015

2016

2017

2018

2019

2020

2021

2011

1

1

1

2

2

2

3

3

TBD

TBD

TBD

2012

1

1

2

2

2

3

3

TBD

TBD

TBD

2013

1

1

2

2

3

3

TBD

TBD

TBD

2014

1

1

2

2

3

3

TBD

TBD

2015

1

1

2

2

3

3

TBD

2016

1

1

2

2

3

3

2017

1

1

2

2

3

9.  Multiple systems can be used to attest to Meaningful Use

  • If you are unhappy with your current EHR vendors portal or your current EHR vendor does not have a portal you can choose to use an EHR independent third party patient portal to attest to Meaningful Use, as long as both systems have 2014 Edition certification.
  • Additionally, talk to both your EHR vendor and patient portal vendor to make sure they will interface.

10. The transitions of care measure in Stage 2 requires providers to “conduct one or more successful electronic exchanges of a summary of care document, with a recipient who has EHR technology designed by a different EHR technology developer than the sender’s,” or “conduct one or more successful tests with the CMS designated test EHR during the EHR reporting period.” CMS now has designated McKesson and Meditech as the first two “Test EHRs,” and seeks more.

11. If you are only eligible to participate in the Medicaid EHR Incentive Program, you are not subject to these payment adjustments.

If you have any questions regarding Meaningful Use or need help with attesting in 2014 feel free to contact me and our team will be happy to help you attest!

Vanessa Bisceglie M.B.A, B.S.,  President,  EHR & Practice Management Consultants, Inc.   www.ehrpmc.com  800-376-0212  847-322-0139

Why are 23% of Physicians Changing Their EHR System in 2013?

In 2013, approximately 23% of physicians stated they were going to trade in their current EHR for a new brand altogether according to the Black Book report.

“EHR system shifters now position to reallocate more than $5 billion in sales as the unstable vendor marketplace begins to get agitated, “ said Doug Brown, managing partner of Black Book, in a news release.

81% of the 23% who noted they were going to change their system are planning to do this in 2014.

This data is understandable.  I have been in the EMR / EHR industry for 11 years and projected the consolidation would start to come in full effect in 2014 as Stage 2 rolls around and we are in the final year to be eligible to collect incentive dollars for Meaningful Use.

Many providers have selected their original system due to price or what a fellow colleague recommended.  The have not taken into consideration that in this industry you either pay now or pay late.  A system that seems to be inexpensive off the bat usually has hidden costs down the road due to not being specific to the providers practice of medicine.  Therefore, the provider ends up spending additional time and/ or money having someone to customize the templates for the system in order for them to use.  Additionally, they may result to using a voice dictation software in order to make up for lost time if they were to try and document their note electronically using the insufficient templates that cam with the system.  Otherwise, they are faced with having a system they purchased and decide to not use it all together.  Either way purchasing a system that truly did not make them time efficient will cost them a financial loss in the long run because they will not be able to see as many patients as they have in the past.  This leads them to be very disgruntled with their current system.  Additionally dissatisfied EHR users cited their current vendors have still not been able to produce the interfaces they promised to deliver to their clients.  Additionally, theses vendors have been unresponsive to their clients requests or have very poor customer support response times.

This is why it is important to choose the correct system moving forward and take into consideration not only short term needs but long term goals of selecting an EHR that will hold your patient’s medical records for many years to come without decreasing your productivity and spending additional monies on the wrong system.  The best system may be more expensive but you should not be discouraged.  EHR contracts can be negotiated and addendums put in for your protection.

If you need help selecting and negotiating the best price with the proper addendums in place for your next EHR I would be happy to help you.  My background for working for some of the leading EHR vendors in the country in sales and implementing several systems across the country allows me to bring the knowledge of the price point providers can actually negotiate their systems down, too.  Additionally, reviewing the contracts enables me to make sure you are purchasing the items and training hours you will need to make sure you purchased enough hours for your implementation to goes smoothly and purchased the right products in order to hit your meaningful use timeline.  If items are left out of the contract that could push back your implementation timeline which can cause you to miss your meaningful use deadlines.

Contact us if you need assistance in selecting a new system:

Vanessa Bisceglie, President, EHR & Practice Management Consultants, Inc.,

www.ehrpmc.com   800-376-0212  847-322-0139