The Office of the National Coordinator for Health IT's Beacon team recently released its first guide to help interested stakeholders learn from the experiences of the Beacon communities in implementing electronic health records.
The first guide, "Improve Hospital Transitions and Chronic Disease Care Management Using Admission, Discharge and Transfer-Based Alerts" is "designed for communities that have a stated goal to reduce avoidable ED visits, avoidable hospitalizations, and preventable readmissions and have identified the implementation of ADT-based alerts as a potential strategy to achieve the goals," according to the authors. The guide covers practical information, such as systems, overview, use of message fields and workflow issues.
The guide is the first of six guides expected to be rolled out in 2013. Other topics to be covered include patient engagement, measurement data and public health. The guides are intended for use by stakeholders of all sizes.
The Beacon Nation project, funded by the Hawai'i Beacon Community, promotes innovation in health IT by gathering and disseminating lessons learned from the 17 Beacon communities. The Beacon Community program is a federally funded project designed to increase efficiency, quality and sustainability of health care though health IT and is slated to end in 2013.
It's one of several programs sponsored by ONC to help the industry transition to EHRs. Other programs include health IT workforce development programs and the funding of the regional extension centers.
To learn more:
- read the learning guide (.pdf)
- learn about ONC's programs
Read more: ONC guide aims to help providers use EHR alerts to reduce readmissions - FierceEMR http://www.fierceemr.com/story/onc-guide-aims-help-providers-use-ehr-alerts-reduce-readmissions/2013-06-10#ixzz2WCckwOEI
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By Marla Durben Hirsch
National Coordinator for Health IT Farzad Mostashari (pictured) has advised providers to take better advantage of their electronic health record systems to improve processes and patient care, according to an article in Government Health IT.
Mostashari, speaking at ONC's Health IT Policy Committee meeting last week, noted that many providers don't have the knowledge to take advantage of these tools.
"We're about halfway through the process of computerizing and digitizing America's hospitals and doctor's offices, and we're about 5 percent of the way through changing workflows and redesigning care to take advantage of those technologies," he said.
Mostashari recommended that providers take three steps to reap more benefits from their EHRs:
- Reach out and engage patients more effectively, starting with those that don't obtain follow up care, but are the most likely to need it
- Redesign processes and workflows, such as using automation and getting patients to obtain follow up tests before returning to the physician's office
- Use protocol-based automatic defaults, such as the use of a statin if a patient's attempts to lower his blood pressure by diet and exercise don't work after a year
The Health IT Policy Committee and the Health IT Standards Committee were both created by the American Recovery and Reinvestment Act to provide health IT recommendations to ONC. Meetings and committee agendas are open to the public.
To learn more:
- read the Government Health IT article
- listen to the meeting and read the materials
Read more: 3 steps for improving EHR effectiveness - FierceEMR http://www.fierceemr.com/story/3-steps-improving-ehr-effectiveness/2013-05-15#ixzz2TUFW0Sqf
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It's an exciting era for healthcare. Aside from the propagation of new devices and technologies that one can spot in any hospital corridor, the very way healthcare will be delivered is under reconstruction. Accountable care organizations (ACOs) link practices under a common standard of payment and care. While they are becoming the norm for how the business and oversight of healthcare is practiced, there are still a lot of wrinkles to iron out. Mike Detjan, vice president of service lines and Greg Chittim, director of analytics and performance, at Arcadia Solutions spoke with Healthcare IT News about three ways that analytics will play a major role in making ACOs functional and profitable.
1. ID heterogeneous data and make it an effective asset. The core idea behind an ACO is that many small practices and organizations, banded together, will be able to provide a wider range of services to a higher standard of care. What happens when each one of those practices has a different EHR system? It's like trying to get a room full of people that all speak different languages to talk to each other. "When you're trying to look at an organization as a whole, how do you normalize that information," asks Detjen. "Having a platform that can normalize that and integrate it is essential." He says having a system that can pull in the diverse streams of information and churn out reliable analytics is necessary because it can build trust across an ACO. "If you don't have the trust in the data, then you don't have a chance to drive change," he says.
2. Understand early wins in a program and establish momentum. With any new change or development, people are going to want to see results and are going to want a reason to continue. It's just good business to be able to show progress and rally troops for the next initiative. This is where analytics can be a powerful tool. Chittim says the first "big win" an analytics-touting ACO can look for is the success and quality of the data being captured itself. He says an ACO feeding good data in to its analytics engines will be the source for all other potential changes. "Making sure that you're improving data quality upfront is a quick win," he says. "The quality of data is pushing up to the analytics is accurately reflecting the quality of care." When it can be demonstrated that the data driving analytics is sound, it can be leveraged to promote and track any number of "performance improvement sprints," says Chittim, who says one can look at analytics to solve two questions: "What's our problem?" and "Where are we now?" as changes are made.
3. Drive engagement with the provider network. There is no element of healthcare that can be described as "set it and forget it." Analytics is an ongoing task, say Detjen and Chittim, and recognizing it as such gives its users the power to drive substantial change over time. One important trick is knowing how to use the data that analytics provides. Detjen cautions against using it to bully. "The physicians out in the field are independent thinkers," he says. "They have their own opinions ... they're the ones out there touching the patients every day." To bring the full force of analytics to bear, he says, "You need a very systematic program that touches the doctors on a regular basis and gives feedback." This way, a constant back-and-forth is kept going, where the input from practitioners informs the analytics that track the quality of care they provide – and vice versa. Chittim describes this as "collaboratively designing where you are when where you want to go, and collaboratively designing how we're going to get there." It all boils down to quality data, open and continuous communications and a desire to leverage new technology to improve care. "Having a trusted set of data," says Chittim, "and teams working together within a healthcare ecosystem – that is what we need to do in order to change healthcare in this country."
You can find the original article here.
Medical billing errors account for $68 billion in healthcare spending each year. And medical experts estimate that between 40 and 80 percent of all medical bills contain errors. If you’re a physician practice, these medical coding errors can cost you a lot of money--and they may lead to your practice getting audited. As such, it’s important to understand how to avoid making high-risk coding errors that will make it more likely for your practice to be audited.
Software Advice, an online resource medical billing software, recently hosted a Q&A with medical coding expert Betsy Nicoletti, MS, CPC. Nicoletti is a nationally-known expert on medical coding and co-author of Codapedia.com. She holds a Masters of Science in Organization and Management from Antioch University New England, and recently published a medical coding book titled, “Auditing Physician Services: Verifying Accuracy in Physician Services and E/M Coding To Protect Medical Practices.”
The Q&A session covers important considerations for physicians practices such as:
- Common high-risk evaluation and management (E/M) coding errors doctors make;
- Prevalent reasons high-risk compliance problems occur;
- Potential consequences of making high-risk coding mistakes; and,
- How to perform self-audits to prevent a legal audit of your practice.
You can read the full Q&A session over on The Profitable Practice at: Avoiding Coding That Leads to Audits: A Q&A With Betsy Nicoletti.
By Marla Durben Hirsch, Fierce EMR
The National Institute of Standards and Technology has taken another step to help the healthcare industry safeguard information contained in electronic health records, issuing a guide to help organizations conduct risk assessments.
The publication outlines a step-by-step process to identify both threats and vulnerabilities within EHRs and other information technology, including:
- how to prepare for risk assessments;
- how to conduct risk assessments;
- how to communicate risk assessment results to key organizational personnel; and
- how to maintain the risk assessments over time.
The guide is written broadly, and can be used not only by healthcare organizations but also financial institutions, government agencies and other entities, according to NIST's announcement.
By Marla Durben Hirsch, Fierce EMR
The Office of the National Coordinator for Health IT has posted its first set, or "wave," of draft test procedures and applicable test data files for the 2014 edition of electronic health record certification criteria.
The draft procedures, which are being developed with the National Institute of Standards and Technology (NIST), will be available for public comment for two weeks after being released, according to ONC's website. The first wave covers 14 certifications, including computerized provider order entry, drug formulary checks, smoking status and automatic log off. It also includes draft procedures for the optional accounting for disclosures certification.
Additional "waves" of procedures will be released during September and October.
By Greg Slabodkin, FierceGovernmentIT, Freelance Reporter
In its ongoing efforts to promote the use of electronic health records nationwide, the Centers for Medicare & Medicaid Services last week announced the final rule to govern Stage 2 of the Medicare and Medicaid Electronic Health Record Incentive Programs.
Under the Health Information Technology for Economic and Clinical Health Act, doctors, healthcare professionals and hospitals can qualify for Medicare and Medicaid incentive payments when they adopt and "meaningfully use" certified EHR technology. The final rule for Stage 2 of the incentive program--which will begin as early as 2014--is designed to increase health information exchange between providers and promotes patient engagement by giving patients secure online access to their health information.
"The changes we're announcing today will lead to more coordination of patient care, reduced medical errors, elimination of duplicate screenings and tests and greater patient engagement in their own care," said Health and Human Services Secretary Kathleen Sebelius in an Aug. 23 press release.
Since the program started in January 2011, more than 120,000 eligible healthcare professionals and more than 3,300 hospitals have qualified to participate and receive an incentive payment. While those numbers exceed the program's qualification goal set earlier this year, CMS still has a ways to go as 4 out of 5 eligible healthcare professionals are currently not qualified under the program.
With the release of Stage 2 rules, eligible doctors, healthcare professionals and hospitals are looking ahead to the next stage of the Medicare and Medicaid EHR Incentive Programs. According to CMS, Stage 3 will "continue to expand meaningful use objectives to improve healthcare outcomes."
Stage 1 set the basic EHR functionality including the ability to capture data electronically and provide patients with electronic copies of health information.
Read more: CMS releases final Stage 2 Meaningful Use rules - FierceGovernmentIT http://www.fiercegovernmentit.com/story/cms-releases-final-stage-2-meaningful-use-rules/2012-08-29#ixzz258MHSqAl
By Marla Durben Hirsch, FierceEMR
Physician adoption of electronic health record systems continues to increase at a steady pace, with about half of all physicians overall using one, according to SK&A's latest survey of physician practices.
The number of physicians in the U.S. using EHRs has jumped to 49.6 percent, up from 45.6 percent in January. Perhaps not surprisingly, larger practices were more likely to have adopted an EHR system, with 78.8 percent of groups of 26 or more physician going electronic, compared to solo practitioners, of whom 41.8 adopted.
Adoption rates are relatively equal throughout the country, with 52.1 percent of physicians in the north and 51.6 percent in the south using EHRs. Slightly fewer (45.5 percent) practices in the East are using an EHR, compared to 49.3 percent in the West.
As any healthcare provider can attest to, figuring out the best ways to map out workflow during EHR implementation can take a lot of the anxiety out of the process. So having a plan to execute workflow activity during adoption, as reviewed here by HITEC LA
, can help ensure you’re in for a smooth EHR transition.
Analyze current workflow
Document the practice’s existing paper workflows in all areas of patient care. This includes everything from front desk admissions to prescription management. Here are some examples:
• Appointment scheduling
• Internal messaging
• Patient visit documentation
• Lab results management
• Prescription processing
• Chart migration
• Incoming paper correspondence
• Billing and accounts receivables
Solicit clinician and staff input regarding roles in current paper workflows
Involve everyone who handles paperwork in the analysis and redesign.
Review and finalize documentation of current workflow
Ensure that the final diagram incorporates the entire “paper trail.”
Identify waste and opportunities; then redesign workflow
Recognizing the steps that should be changed to improve office functionality and know your EHR needs. During the workflow redesign, you assign pre-work before meetings or even homework, where personnel may be required to collect additional inputs or data collection following the meeting. This will help prepare them for the transition.
Identify and implement the EHR system and new workflow
Enlist the necessary support and work with the right EHR vendor to implement a system that meets the practice’s needs; ensure proper EHR implementation through staff training on the new workflow. This may not be easy for physicians or nurses who barely ever use computers. Ensure their comfort during the workflow during the transition is a big key to the process. During training, using screen shots and/or live activity will help physicians and nurses get a good feel for EHR as it pertains to their everyday work.
Analyze new EHR workflow and refine as needed
Continue to monitor the EHR-driven workflow and adjust it to optimize efficiencies in your practice. If staff continues to struggle, bring back training staff for a refresher.
to view a workflow chart and see the original article
Full EHR by 2014, means that hospitals need to implement Electronic Health Records in their practice to ensure effective administration of the healthcare sector; the current federal procedures require that hospitals and other healthcare institutions should adopt the EHR/EMR systems by 2014. The implementation process includes:
Planning for transition and staff training
To successfully implement the EHR; each hospital needs to plan for transition from paper to electronic systems. The most essential thing is to ensure that the personnel are well prepared for this transition; there should be adequate training of all the staff that is expected to use the systems. People skills such as communication, leadership, and staff training are mandatory to successfully implement it. This therefore calls for an effective change management and reshuffle in various departments to ensure there is a new information managing paradigm in healthcare.
The organization must make the decision of whether to use the integrated systems strategy or to employ the `best of breed’ approach early enough. Other decisions that the organization should make is whether to look for commercial vendors or to produce the clinical IT system personally to cut on costs.
The organization then moves to the process of actual acquisition of the system; the decision on what acquisition process to use should be made carefully. This is ensure that the organization acquires the best system to fit their needs.
Implementing the system
Implementing the system requires the help and support of every member of the organization; every member of the staff should be familiar with their role in implementing the system. Staff cooperation therefore, ensures that the system work well; system control and evaluation also becomes easy.
After the system has been put in place and it becomes operational; any errors should be identified and corrected.
EHR benefits and acquiring market share.
Having the right EHR not only makes the organization acquire efficiency but it also helps them to gain a market share in terms of technological progress.
They improve the documentation of hospitals records with legible and organized data through integrated practice management softwares.
They improve the E&M coding accuracy and comply with audit regulations by ensuring correct data, procedures and diagnosis codes.
The systems reduce billing errors and assure privacy of financial reports of a hospital; they eliminate any loss of charges, make coding easy and increases hospital revenue.