EZ EHR Consulting

First You must crawl before you walk.

A lot of studies have recently come out looking at productivity declines that are typical following the implementation of EMRs. Everyone expects the decrease in productivity because of the disruption in workflow.

The studies also point to two key takeaways. Map out and analyze your office or department’s workflow to see where inefficiencies can be squeezed and where information technology can create efficiencies. This mapping and analysis takes time to really get a handle not only on the physical processes but the cultural and historical reasons things are done the way they are in the office. Once you tease out the reasons, your office may find a process may be obsolete and be eliminated or it needs tweaking for greater efficiency.

Mapping and analysis should take place long before your office looks at any EMR systems. It should be an early task on the to-do list, and it should involve all stakeholders so no one feels left out of the major transformation that will be impacting the office. It can take place in tandem with researching EMR systems and matching EMRs to the new workflow that is being created for the office.

This is a service in which local consultants likely have expertise, so take advantage of your local consultant to help get through this important step, especially if your office is a small practice. Once your office has re-engineered a new workflow process, then your staff can evaluate what EMR system best matches how your office works. Again, consultants will have this expertise.

Consider it cleaning house before the big changes come. With everyone on staff having a working knowledge of best practices and workflow changes, the big transformation may not be quite as disruptive, relatively speaking.

The debut last week of the iPad3, or “the new iPad” as Apple officials are calling it, has the IT world at large abuzz. But is it a slam-dunk for healthcare? A few of its new functions have certainly caught the eyes of healthcare providers.

The big one: The new “retina display,” which experts say will make imaging a breeze on the new device. The display is supposed to completely dissipate the pixelization so common to tablets now, and fool the eye that it’s seeing a true image, not a digital representation, according to a Q&A on the new iPad that ran in the UK’s Guardian newspaper.

“For pictures and other display objects, the improved resolution is–from our limited experience–a bit like the change from standard TV to HDTV. You notice the change as a dramatic leap at first, then get used to it,” the Guardian writes.

More core processing power, too, could alleviate some of the hiccups for tablet use in healthcare. The new iPad has an A5X, quad-core processor, which reviewers at iMedicalApps.com predict will make apps run faster, plus allow easier movement between apps and other software on the device. They even project that “the faster processor could help with screen sharing and remote control apps (e.g. Citrix),” which would be a relief for the host of hospital CIOs using Citrix porting for their EMRs.

Faster processing could solve one problem identified in an imaging study last year, which found that iPad2′s, while equal to LCD monitors for viewing, were about twice as slow in accessing the images.

The new 5 mega-pixel camera may make the iPad a real player in the telehealth market, iMedicalApps opines. The A5X processing, combined with the new cameras ability to record video in 1080p HD resolution, could “offering increasing resolution in a telehealth care setting,” they say.

One rather unexpected development is a new button allowing users (i.e., physicians) to dictate. It’s unclear yet whether the dictation software can handle medical terms, but it certainly offers the ability to record patient notes and enter discrete data into an EMR application, iMedicalApps reviewers say.

We checked into a brief LinkedIn debate this week, and users seem to be divided over the iPad3s fit for healthcare. One eagerly anticipated the better screen resolution and faster speeds. However, another warned that old problems still remain in the new iteration–keyboards that are tough to use one-handed, lack of true stylus support (for onscreen signatures, etc.), and the 10″ screen size, which forces uses to scroll or slide to see everything on a patient record.

Don’t way we didn’t tell you!

Accenture study shows that government incentive programs to spur adoption of EHRs have helped the U.S. outpace other nations in healthcare IT.

HHS announces intent to delay ICD-10 compliance date

As part of President Obama’s commitment to reducing regulatory burden, Health and Human Services Secretary Kathleen G. Sebelius today announced that HHS will initiate a process to postpone the date by which certain health care entities have to comply with International Classification of Diseases, 10^th Edition diagnosis and procedure codes (ICD-10).

The final rule adopting ICD-10 as a standard was published in January 2009 and set a compliance date of October 1, 2013 – a delay of two years from the compliance date initially specified in the 2008 proposed rule.  HHS will announce a new compliance date moving forward.

“ICD-10 codes are important to many positive improvements in our health care system,” said HHS Secretary Kathleen Sebelius.  “We have heard from many in the provider community who have concerns about the administrative burdens they face in the years ahead.  We are committing to work with the provider community to reexamine the pace at which HHS and the nation implement these important improvements to our health care system.”

ICD-10 codes provide more robust and specific data that will help improve patient care and enable the exchange of our health care data with that of the rest of the world that has long been using ICD-10.  Entities covered under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) will be required to use the ICD-10 diagnostic and procedure codes.

Watch here for more news

Calling 888-734-6433 will connect you to the CMS EHR Information Center Interactive Voice Response System (IVR) System.

The upgrades will enable EHR Incentive program participants to obtain information on the program easily and more efficiently. From the main menu, press 1 for Hot Topics and press 2 for Information on NPPES and PECOS password resets. There are 8 hot topics and 2 selections the NPPES and PECOS. The service is available 7/24 except during planned system maintenance. The TTY number is 888-734-6563. You can also speak to a specialist through this system also by pressing “0″. The hours of operation for the EHR Information Center are Monday through Friday, 7:30am to 6:30pm CST except federal holidays.

Along with changes to the IVR system, CMS has also updated information on the EHR Incentive Programs on their web site. You can find new information on the Attestation pages about the appeals process for the program. Appeals for Eligible Professionals, Eligible Hospitals, and CAHs have been accepted since last December. The CMS Office of Clinical Standards and Quality (OCSQ) is also providing guidance on how to file an appeal. Their Division of Health Information Technology is tasked with review of appeals. On January 19th the division released the first informal review decision for the EHR Incentive Program. CMS expects informal review and appeal decisions to be posted on their web site by February. And by March, providers will be able to find receive their decisions through an appeals portal.

By J. Scott Litton, Jr., MD | January 20, 2012

As scary as workflow analysis may sound it may be something as simple as seeing if your staff can type accurately and quickly?

While unemployment hovers between 8 percent and 9 percent, many of us in healthcare have positions we are eager to fill. Applicants’ resumes come in by the dozens via e-mail. However, while some people look extremely good — on paper — you might wonder: “Can they really do the job?”

Whether your position calls for the person to work as an EHR scribe in the exam room, as your Web specialist, or in the business office working on coding and billing, the ideal employee needs solid keyboarding skills and typical knowledge of Microsoft programs, on top of the required expertise in anatomy and terminology, and procedural and diagnostic coding.

Assessing the capabilities of all applicants will help you verify their skills, knowledge, and abilities. Consider that someone with minimal keyboarding skills can be an expensive hire for your practice; potentially reducing efficiency and introducing errors into the medical chart.

Prior to implementing your EHR (or upgrading to a more robust system), you’d be smart to assess the skills of your entire staff. You may decide that investing in more-focused training is worth the extra expense. Online training for Microsoft programs is readily available, and is a particularly good idea if your new software is a “jet engine” and many of your staff have only “fly-a-kite” abilities.

Because “keyboarding” is the foundation for computer usage we can assist in setting up simple tools to test with.  Tests can be downloaded to a computer and the cost is only $19.99 — with the entire staff able to access it. In one of our clients’ office, the physician was shocked to discover that while his favorite applicant had a 97 percent accuracy rate, she could only type 14-words per minute! This applicant would sink at a busy check-in desk. Speed counts!

Remember, employee productivity is a combination of intelligence, speed, and accuracy at the keyboard.

We particularly like the Health Care Employee Productivity Report (HEPR).

http://www.creativeorgdesign.com/tests_page.htm?id=109

The 60-question tool can be completed in about 15 minutes and provides behavioral and attitudinal feedback on applicants. It is compliant at the state and federal level. Managers receive recommendations about hiring a potential candidate, based on the scores. Because of the costs of interviewing, screening, and training are so great, heading off bad hires at the pass makes good sense.

For more simple tips keep watching or give us a call.

If you’re a healthcare provider hoping to snag some federal money through the U.S. Centers for Medicare and Medicaid Services’ electronic health records incentive program, you’ll want to be mindful of some important upcoming deadlines to make sure your practice is eligible to receive an incentive payment for 2011.

Feb. 29, 2012 – Eligible professionals have until to register and prove that they meet meaningful use requirements to receive an incentive payment for calendar year 2011 through the Medicare and Medicaid EHR Incentive Program Registration and Attestation System.

Feb. 29, 20121 – Also the deadline for eligible professional to submit any pending Medicare Part B claims from calendar year 2011. CMS gives providers a window of 60 days after Dec. 31, 2011, to process all pending Medicare claims. This means that providers have 60 days in 2012 to submit claims for allowed charges that were incurred in 2011.

MU Medicare EHR incentive payments to eligible professionals are based on 75 percent of the Part B allowed charges for covered professional services provided by the participating professional during the entire payment year.

According to CMS, incentive payments for the Medicare EHR incentive program will be made approximately four to eight weeks after providers demonstrate that they have met the meaningful use standards of certified EHR technology.

However, eligible providers will not receive incentive payments within that timeframe if they have not yet met the threshold for allowed charges for covered professional services furnished by the provider during the year. If providers do not meet the $24,000 threshold in Part B allowed charges by the end of calendar year 2011, CMS said it expects to issue incentive payments for eligible providers in April 2012 for 75 percent of the provider’s Part B charges from 2011.

Medicaid Incentives – Check with your state. For providers participating in the Medicaid EHR incentive program, those incentives will be issued by individual states, so the timing of payments will vary according to state. CMS advises professionals to contact their state Medicaid agency for more details about time of payment.

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