Posted by barbarahales

The problem with EMR implementation is dealing with the merge between treatment and technology for the doctors. They are having a hard time combining the EMR and are blocking or misusing the EMR.

I still see doctors using paper charts with their EMR. That is not how it is supposed to work. They are creating more issues and more steps.

Helping doctors meet meaningful use is easy for the EMR companies but not for the doctors. The problem is that consulting does not combine treatment and EMR.

The American medical industry is going through a change of how patients are cared for. We’re moving from diagnosing a problem when it comes up, to moving to a preventive medicine culture.

The key is teaching and consulting with the physicians to combine their human manual process with the EMR.

The problem is that a lot of the EMR companies’ software is not flexible. EMR software needs to allow the medical practices, clinics or hospitals to merge their work-flow (human manual treatment process) around the technology. They should not have to change their process. Very few EMR software companies allow this.

Software should be built around the doctors’ workflow treatment of their patients.

One big issue is with CCHIT or others trying to enter the certification market. Certification needs to have a defined process on workflow and how it evolves around practices, clinics and hospitals. It doesn’t set a base on how the software should meet needs of the physicians.

Hopefully in time and maturity of the market we will see the combining of treatment and technology like the orthodontist and dental market.

This article was submitted by a guest today- Ed Brown

Eddie Brown is  President of EA Brown & Associates VAR for MedComsys IPatientCare EHR. He has over 17 years of experience selling document management, messaging, document capture and transaction management solutions and enterprise solutions for the banking, insurance and health care vertical markets. P:404-667-5006

Posted by barbarahales

Surprisingly, at a time when Berwick,  the new appointed head of CMS (Centers for Medicaid and Medicare Services) states that he greatly admires England’s National Health Service, England is going to decentralize theirs!

In a new surprising and radical move, Britain’s new coalition government has remarked that it will revamp their healthcare system which has been in place since 1948.  Although exact details have as yet to be disclosed, England plans to shift its $160 billion yearly health budget away from a centralized bureaucracy to physicians at the local level.  Family physicians will receive the money to buy services from hospitals and other healthcare providers.

By effecting this change, the government can save up to 45% in administrative costs.  A representative stated “Liberating the N.H.S. and putting power in the hands of patients and clinicians means we will be able to effect a radical simplification and remove layers of management.”

Andrew Lansley, the health secretary also vowed to empower the patients. Rather than decisions left to primary care trusts, the patients themselves will now be able to decide where they will receive their exams and treatments  which will also decrease the length of waits for their medical care.

Steve Field, chairman of the Royal College of General Practitioners, states “This is about clinicians taking responsibility for making these decisions.”. “It will be able to focus on what local people need”.

Until now “there were far too many bureaucratic hurdles to leap” in the system and “in many places, the communication between G.P.s and consultants in hospitals has become fragmented and distant” according to Dr. Richard Vautrey, depty chairman of the general practitioner committee at the British Medical Association.

The change facilitates the shift to privatization of healthcare. Isn’t it ironic that the system of care that We used to have, is the best one after all?!

Posted by barbarahales

It has been proposed that 3^rd party systems who had been exempt from HIPAA, like billing companies, customer service contractors and others who received patient information, should be held accountable at the same degree as hospitals and healthcare providers. Violation of privacy rules would subject them to fines.

This is not just a slap on the wrist. HHS increased the maximum penalty for violations to $50,000 per violation and $1.5 million per year.

The Office for Civil Right’s regulatory power over HIPAA’s privacy would be strengthened by this proposal along with greater accessibility for personal data to people.

According to David Blumenthal, the National Coordinator of Health IT, “This rulemaking will strengthen the privacy and seurity of health information, and is an integral piece of the administration’s efforts to broaden the use of health information technology in healthcare today”.

Additionally, the new proposal restricts personal information disclosures to health plans.

Change to current security practices would encourage more people to submit their information to personal health records and pave the way to improved or greater usage of information on electronic health systems as we move forward in the digital realm of medical practice.

Posted by barbarahales

Red Flag Delay

Yes, you have read this before- four other times before as a matter of fact.

This is the fifth time that the FTC announced a delay in enforcement of the Red Flags rule, changing the compliance deadline from June 1 to Dec.31.

As you may recall, the Red Flag rule designates doctor’s practices and other small businesses as creditors, thereby requiring them to submit identity theft and prevention strategies in writing. This would pertain to all offices that bill patients, so that it seems the office is extending credit to the patients.

The purpose of the delay is to allow lawmakers time to consider proposed legislation that woud exempt small businesses including doctor’s offices with fewer than 20 employees from the Red Flag rule. This is also in response to the law suit filed by the AMA, AOA and the Medical Society for the District of Columbia.

What are your thoughts?  Don’t you agree that owing your copay for a medical visit is not really like the physician’s office giving you a “loan” even though it may be the case in the strictest sense of the law?

Posted by barbarahales

We have often seen that for many businesses, when following a code of ethics translates to losing money, their mantra is “there is no ethics in business”.

Apparently this is what Glaxo- Smith-Klein subscribes to.  In doing their comparison study between Avandia and Actos for diabetes, the  cardiovascular risk and death came to light.  Instead of pulling the drug or at least warning the public, they spent their efforts on trying to hush up the information.  Countless lives have been lost so that GSK can realize millions of dollars.

But the scariest thing is not even this mantra. It’s the stance that the FDA is taking.  Yes, the FDA, the arm of the government that we place our faith in- the one that approves drugs so that we can assume they are safe to take.

The FDA is debating whether to withdraw Avandia from the market because for those (that don’t die) there is some benefit. This is the belief of Dr. John Jenkins, director of the FDA’s office of new drugs, according to documents.

Criticized by the FDA for suggesting that the public should be warned about the risk in a stronger fashion, Dr. Rosemary Johann-Liang, formerly the supervisor in the drug safety office of FDA, states “This should not happen, and the fact that these kind of things happen, I think people have to make a determination about the leadership at the FDA”.

I agree.  Don’t you?  Let’s hear a public outcry about the fact that a debate even takes place. It can start with you!

Let’s vote to bring in ethics!

Posted by barbarahales

Congressional fireworks have been averted while away for the 4th of July holiday.

The Centers for Medicare and Medicaid Services (CMS) just got a new head. Dr. Donald Berwick, a pediatrician and leading promoter of patient safety and quality improvement in healthcare was just appointed to the post of Administrator.  Turns out, Dr. Berwick can be appointed by the President who sidesteps normal procedure of a Senate confirmation process.

The loophole that most people are unaware of, is that during the time that the Senate is in recess (like the 4th of July holiday), the President can appoint who he wants without approval, avoiding the traditional route.

Normally, the Senate Finance Committee would have conducted a hearing on the nomination involving questions from supporters and critics after which the nomination report would go to the full Senate for a vote.

Supporters feel that Dr. Berwick is a natural choice to help implement the healthcare reform legislation, having been CEO of the Institute for Healthcare Improvement which has helped healthcare providers and facilities to improve patient care.  Critics (like Senate Republicans) blast Dr. Berwick as a supporter of healthcare rationing and socialized medicine. They feel that he is being “snuck” in without explaining his position on national health service or medical rationing. As he is to take office imminently, we will find out how he feels about these issues first hand.

Posted by barbarahales

Happy 4th of July to everyone.

While we are enjoying the beach or a family barbeque, let us remember our countrymen in the military and how they are fighting for us.  Let us also rejoice in the freedoms that we have.

It is wonderful that regardless of our political leanings, our ethnic backgrounds, educational or social standings, we can all come together to celebrate the fact that we are all Americans.

My chest swells with pride.  I hope yours does too!

Posted by barbarahales

Rewarding healthcare facilities and physicians with reimbursement incentives to convert records to an electronic system and go paperless might have gone by the wayside with Medicare reimbursement declines. So, other incentives may come into play….like “threats”.  Adopt electronic medical records or lose your license to practice medicine.  This is what Massachusetts is currently looking to do- making meaningful use EHRs a requirement for obtaining a medical license (or keeping one).  So, today’s choice may not even be a choice in the future!

John Glaser, adviser to the Office of the National Coordinator for Healthcare Information Technology (ONC) states “We’re going to go through a hell of a lot of change in healthcare IT in a relatively short period of time.  Some states will screw it up”.  He feels that some information exchanges won’t work and that the road ahead will be bumpy.

Posted by barbarahales

Posted by barbarahales

Today President Obama signed into law the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, more commonly known as the “doc fix”.This defers the slashing of Medicare reimbursements to doctors by 21.3% for services rendered as of June 1. However, this “reprieve” is only in effect until November.

Mr. Obama stated “I believe we need to permanently reform the Medicare formula in a way that attacks our fiscal problems without punishing our hard-working doctors or endangering the benefits on which so many of our seniors rely”.

Although grateful that the cuts have been staved off, most healthcare providers and leaders of organized medicine are repulsed by the lack of a permanent solution. According to Lori Heim, M.D., president of the American Academy of Family Physicians, “piecemeal approaches merely continue the uncertainty about the reliability of Medicare”. “The stability of federal payment is crucial to the success not just of Medicare but health reform as well. The health reform legislation calls on physicians to invest in changing their practices with health information technology, with new practice models that take time and money to implement, with new accountability standards and performance measurement reporting. Physicians can’t invest in change if they can’t count on payment for their services.”

Upon the termination of the new bill in November, Medicare cuts are slated to be slashed by 23% and then elevated to 30% by January.

It is clear that most physicians are uneasy about the shaky, temporary stability of Medicare reimbursements. For those doctors that still accept payment of Medicare, many are reevaluating their situation. They are weaning themselves from the system by decreasing the number of Medicare patients they see, limiting the practice by not accepting any new patients and seriously considering separating themselves out of fear from reliance on the government program.

For many physicians, the decrease in Medicare reimbursement is more than just a diminishing of salary despite increased expenses. It is a fight for economic survival to keep their doors open. This is one more nail in the coffin of private practice as we know it.