Category — RMC Articles

For the Times-Standard

Tech Thursday
“Cloud-Shrouded, Whereabouts Unknown-A Digital Healthcare Metaphor”
By Erin Stevenson
Posted: 03/04/2010 01:30:25 AM PST

Forty years ago, when Zen Master Alan Watts wrote about finding his refuge on Mt. Tamapalis in CA., little did he know he was also writing about the current state of affairs in the healthcare industry.  Confronted with a shrinking deadline to “go digital”, if health care providers hope to capture some of the federal stimulus monies available through the government’s “HITECH” program, there is a huge maze in front of them.

However, when a provider knows the right questions to ask, the chances of succeeding increase dramatically.  We’re going to look at six of the best questions providers can ask to insure they’re “on the path” as Alan liked to say.        

 1.     Have you considered using a Consultant to help identify those vendors that are a good fit for your practice? (Consultants can also function as Project Managers, or “Trusted Entities” that can manage some or all of the requirements for transitioning into a digitally-based practice and should be one call away when a problem arises)

 2.     Do you know that your risk of success increases when purchase “mixed” or ‘interfaced” systems?

Those who only purchase an EHR system, for example, may quickly find that they have no way to transfer their clinical documentation into accurate billable data and important clinical alerts. Traditional EHR applications are often “cobbled” together with an existing practice management system and the two products may not interface properly.

 3.     Do you understand the importance of “Point of Care” Usability?

A critical component to any comprehensive EHR solution is that it offers total point-of-care workflow and usability. Physicians, nurses and all other care providers must be able to quickly access and document patient information directly from the point-of-care without inhibiting any aspects of the patient’s visit-this directly contradicts how many EHR systems were not initially designed.

 4.     Are Health Care Providers making upfront “Apples to Apples” comparisons of the best EHR Systems and Solutions?  

It is important to remember that when comparing EHR systems, providers should demand a comprehensive review of all associated costs for their practice during a five-year-period.

 5.      Are health care providers aware of inherent dangers in purchasing an EHR from a company that does not provide end-to-end solutions or support?

The fourth biggest mistake providers make is not realizing that EHR companies will do everything in their power to get you hooked realizing that, once you’re hooked, you’re hooked. If a system issue arises and you’re not able to track down an immediate cause or reason, the multiple companies involved traditionally point fingers at each other and leave the practice frustrated and in the dark.  [Here’s yet another reason to use a Consultant or “Trusted Entity” where one phone call can transfer the responsibility of figuring out a solution to them and frees up the provider to continue working with their patients]

 6.      As a provider, are you underestimating the importance of a clinical template library or the ability to easily create one that meets your unique needs?

Many EHR systems force every provider to create their own documentation and procedure templates. This is usually a daunting and time consuming process.  If an EHR system comes with a library of templates-great.  If not, can the provider or consultant easily and quickly create templates that can immediately be integrated into their work flow?

And finally,

 7.      As a provider in the EHR market, do you Understand that “Free” is Not always a BAD word?  Or, do you automatically assume that “free” is suspicious and untrustworthy?  In this very competitive environment, as Marshall McLuen said those many years ago, this assumption has outlived its uselessness.

          Very reputable vendors are offering a host of services free to help providers maximize their “HITECH” subsidies.  It’s not as if the vendor is losing in the proposition.  The reality is that they have found other avenues of revenue that offset the cost of offering “free” services.  Providers win in that they can reap the benefits from these free services and reinvest the subsidy monies to offset hardware, training, and related costs to “going digital”.

Look, you’re busy & your staff is busy.  There are very significant decisions to make if you’re aiming at being eligible for some of the “HITECH” subsidies.  You really don’t have to agonize over transitioning to an EHR system! There are expert guides out there. Use them to stay on “the path” and enjoy the view. 

Erin Stevenson is a Digital Healthcare Consultant. He has an Advanced HIPAA Certification, including Security Levels I & II and Dual Membership in HIMSS [National and Regional] and is a member of the Redwood Technology Consortium. Visit www.redwoodmedicalconsulting.com for more information.

For the Times-Standard

Tech Thursday
“What will the paperless medical revolution look like?”
By Erin Stevenson
Posted: 12/03/2009 01:30:25 AM PST

The medical revolution is here…and you are invited.  Spurred by President Obama’s “HITECH” program, health care providers can earn a sizable subsidy by giving up paper charts and exchanging or updating medical records digitally (health care providers include “Eligible Practitioners” which includes MDs, DDSs, PAs, Certified Mid-Wives, Community Clinics, Indian Health Services and rural health services managed by an “Eligible Provider” i.e. PA.). The past way of handling your office, is not forgotten, it is redefined – the future is exciting.  And it may work out that your out-of-pocket costs will come close to near zero.  However, certain tax breaks allowing for 100% write-off of software and hardware (IRS Code 179) expires at the end of the year (it may be renewed, but as of this writing, no action has been taken).  Another incentive to consider is that beginning next year, physicians will have to endure a 21.2% cut in their Medicare reimbursements, making the transition to a more cost efficient digital system all the more attractive (and without a “doc fix”, that reimbursement cut will rise to 40% by 2016).  Check our website for continually updated news on the HITECH program.

The promise is better quality patient care, easier exchange of records, fewer medical mistakes, lower cost to the patient, and a better bottom line for the provider.

Choosing a system with both a smooth transition with minimum disruption or loss of productivity is a tall order. The system should be easy-to-use, customizable, talk to other digital systems and not interrupted by internet failure, fiber optic cable, too many bugs, or hackers.

Fortunately many medical software providers allow many choices. With numerous ways to configure a system, there are easy-to-learn and use-proven systems that allow a small practice to grow.  Unfortunately some systems have caused as many as 20% of practitioners to revert to their old methods of paper charting.

Many potholes can be avoided by taking the time to investigate the strengths and failures of systems available.  Hiring an informed consultant who can successfully guide you through the maze for a good and lasting solution to meet your immediate needs, long term growth, and an impressive return-on-investment is a good start, too.

Consultants will use four models from which you will choose:  SAAS, Web-based, Web-enabled, or Client-Server. From the chart below you will see the options each choice gives you.

All must meet the same criteria, satisfy revenue, provide timely information, quick response to data requests, minimize human resources, minimize downtime, satisfy regulatory/compliance issues, and inter-operational ability with other systems.

Rules of Thumb:

1.         Avoid purchasing interfaced systems – The potential for disrupting the flow of Current  Procedural Terminology, (also known as CPTs-the most widely accepted medical terms used by health care providers to report medical procedures and services under public and private health insurance programs) or ICD-9 (the ninth version of the International Classification of Diseases) codes is high. [There’s a new expanded ICD being developed and will be available in 2013]

2.         Don’t overlook point of care usability –Physicians and other providers want quick documentation of patient information without interrupting aspect of visit.

3.         Make upfront “apples to apples” comparison for best EHR systems and solutions.

Remember comparing EHR or (Electronic Health Records) systems demands a comprehensive review of all associated costs to your practice for a 3-year period including: Software fees, annual upgrade and support, hardware costs for all care providers, third-party database fees, implementation, installation, training fees for appropriate hours, and other costs related to your patients.

4.         Don’t purchase an EHR from a company who doesn’t provide end-to-end solutions or support.

Some EHR companies do everything possible to get you hooked, because once you hooked, you really are hooked.  Therefore, I strongly suggest that you purchase an EHR from a company that supports all aspects including software, hardware, training and support. They should always be one call away. Their ability to handle all of your requests will greatly increase your overall success and provide a maximum return-on-investment.

 5. Don’t underestimate the importance of templates.

Many EHR systems force you to create your own templates. This is a time-consuming task.  Physicians and users who have a library of templates are far ahead in documenting patient encounters especially in the first few days of implementation.

The Redwood Technology Consortium (redwoodtech.org) is a good place for the local medical profession to look for technology-related education and developments.

Erin Stevenson is a Digital Healthcare Consultant. He has an Advanced HIPAA Certification, including Security Levels I & II and Dual Membership in HIMSS [National and Regional] and is a member of the Redwood Technology Consortium.  Visit www.redwoodmedicalconsulting.com for more information.