Archive for January, 2009
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2 Don’t Delay – Now is the time for EMR
Jan 28, 2009. Today.2009 is upon us, and it is a time for new beginnings. Many people view January as a time to start over with a fresh take on life. This year we have a new congress and a new administration in the White House. Obama is pushing for advances in health care IT, as we know.
Obama’s economic stimulus package hits the House floor today. One of the line items in the bill includes $20 billion for health IT. The goal is to create jobs through pushing computers into doctors’ offices. Currently only about 17% of all physicians use computers or an electronic medical record in their offices.
Using computers in medical practices requires more than just hardware. Physicians will also need software, training, networking infrastructure, and installation. Analysts predict this plan would create about 200,000 new jobs to successfully implement the new program.
The devil however, is in the details. Those details are somewhat murky at this time, but we can assume the plan will call for standard hardware and software for every office. Dell computers running Windows Vista might be a likely choice, for instance.
If you do not already use an EMR in your practice, you may soon be required by law to adopt one. The stimulus package means well, but it could require physicians to purchase a certain brand of computer, certain software, and most likely an electronic medical record that meets government-defined criteria. You may also need to hire more staff to help support the new system. Although the federal government will fund the program, it is unlikely that physicians will not have to pay for some things.
Do not wait until Washington forces your hand. If you don’t currently use an EMR, now is the time to start shopping. Implementing an EMR is a big decision. You want to have plenty of time to find a system that meets your requirements and fits with your budget. The last thing you want is to be forced into a system you have no control over.
Ryan Ricks
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Security Officer
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0 What You Should Know
Jan 28, 2009. Insight.It is evident that the year 2009 is the year of Health Information Technology. Obama is just the icing on the cake with the $50 billion announcement to assist a smooth transition to electronic medical records
As a result, physicians and healthcare staff will be in a frenzy trying to determine which electronic medical record system to purchase.
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0 Personal Web Records – Benefit or Liability?
Jan 26, 2009. Implementation, Today.Personal Health Records (PHR) are a handy way for patients to keep track of their medical information. PHRs can benefit everyone, but they are especially useful to those who see many different doctors and take several medications at one time. Doctors may not be aware of every medication their patients take if their patients see many different specialists. Personal health records help break down these information silos and give each physician better information about their patient.
Medicare allows its beneficiaries to store their health records online with one of four companies: Google Health, HealthTrio, NoMoreClipboard.com, and PassportMD. Web based services are handy because the patient can access them from anywhere with an internet connection, and they do not have to worry about carrying around a small USB drive. Many of these web-based PHRs offer additional services, such as interfaces to pharmacy data, drug interaction databases, and diet tracking tools.
While handy, web-based PHRs have a couple of drawbacks. First, they are out on the internet, so security is not guaranteed. Just like online banking, web-based PHRs usually have pretty robust security. The weakest link is usually the passwords users choose to protect their accounts. State of the art encryption and best practices count for nothing if patients use a password that an attacker can easily guess. Furthermore, there are many incidents where hospitals have leaked patient information onto the internet because their web servers were miss-configured.
Second, you need an internet connection to access your data. If you are on vacation, on the road, or anywhere without connectivity, your data is inaccessible. This may not seem like a big deal, but consider what would happen if you are in an accident. USB-based PHRs are instantly available to any EMT or emergency worker. They can access your health records almost instantly. This is not possible with a web-based PHR.
USB-based PHRs are a better choice, because the patient carries them at all times. XLEMR’s PHR, the Medical Information 5 card, is contained in a slim USB drive that fits in your wallet. Robust military-strength AES encryption protects sensitive health documents should the card be lost or stolen.
Personal health records are a great way for patients to keep track of their information, but they must keep security in mind. Patients have to strike a balance between safety and fast access to information with their privacy and security. That is a decision only the patient can make.
Ryan Ricks
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Security Officer
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2 Obama’s big idea: Digital health records
Jan 23, 2009. Government Initiatives, News.David Goldman, staff writer for CNNmoney.com summarizes Obama’s proposal to digitize health records and discusses the obstacles and advantages of the plan. You can view the article in its entirety at the link provided.
http://money.cnn.com/2009/01/12/technology/stimulus_health_care/index.htm
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0 Complete The Work On Health Information Technology
Jan 23, 2009. Today.David Brailer, M.D., Ph.D., was appointed the first National Coordinator for Health Information Technology by former President George W. Bush. A giant in the industry, Dr. Brailer provides his thoughts on the future of health information technology in the United States. You can view the entire article at the URL provided.
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1 BARACK OBAMA AND JOE BIDEN’S PLAN TO LOWER HEALTH CARE COSTS
Jan 19, 2009. Today.Health care costs are skyrocketing. Health insurance premiums have doubled in the last 8 years, rising 3.7vtimes faster than wages in the past 8 years, and increasing co-pays and deductibles threaten access to care. Many insurance plans cover only a limited number of doctors’ visits or hospital days, exposing families to unlimited financial liability. Over half of all personal bankruptcies today are caused by medical bills.2 Lack of affordable health care is compounded by serious flaws in our health care delivery system. About 100,000 Americans die from medical errors in hospitals every year.3 One-quarter of all medical spending goes to administrative and overhead costs, and reliance on antiquated paper-based record and information systems needlessly increases these costs.
Read the full plan at http://www.barackobama.com/pdf/issues/HealthCareFullPlan.pdf
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0 2009 AMDA Annual Symposium
Jan 19, 2009. Today.XLEMR will be attending the 2009 AMDA Annual Symposium in Charlotte, North Carolina, March 5th through the 8th at the Charlotte Convention Center. Come see us at booth # 304, and don’t forget to watch our presentation in the technology pavilion. We are presenting Friday, March 7th at 10:30 am.
This year’s theme is “Partnering for Success: The Sky’s the Limit.” The convention focuses on long term care medicine, and offers many sessions from insightful speakers. In addition, you can network with colleagues, and enjoy recreational activities like guided tours and pottery painting.
XLEMR’s XL-Mobile product focuses on mobile geriatric and long term care practices. It runs right from your laptop or tablet, and supports infinite customization. Be sure to visit us at booth # 304, and ask how you can earn $1000 for trying out our software. Our website offers free software and geriatric template downloads.
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1 HIT Jobs Creation – a long time coming
Jan 18, 2009. Politics and HIT, Today.With President-elect Obama’s proposed $20B over 2 years for HIT, he appears to be hoping to create 212,000 jobs, as in the previous post. Let’s do the math. This is $47,000 (give or take a couple hundred dollars) per job per year.
Of course, it would be expected that a significant portion of, and probably the majority of the $20B will go to software vendors, hardware vendors and even physicians, and a minority of it will end up as salary for new jobs.
There was another bill recently introduced, and favorably received but never passed, that would have allocated $100,000,000 for the anticipated production of 10,000 jobs. For those mathemeticians amongst us, 10,000 squared is exactly 100 million, so that it was expected that it would cost the federal government $10,000 per new person trained. The full text of the bill is appended at the bottom of this post.
While admittedly mixing apples and oranges, or more accurately mixing training costs and employee salaries, there does seem to be a longer term trend towards increasing th enumber of HIT jobs in America than one would have expected from viewing the actual legislation that has passed through both houses of congress and been implemented.
We are all hoping that we find the proper trade-off between saving money and training and employing new people, to allow for the best quality medical care, at an affordable price, while not lowering physicians’ salaries in the process.
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As seen http://www.govtrack.us/congress/billtext.xpd?bill=h110-1467
HR 1467 RFS
To authorize the National Science Foundation to award grants to institutions of higher education to develop and offer education and training programs.
SEC. 2. FINDINGS.
The Congress finds that–
(1) the National Science Foundation has long been a government leader in strengthening our Nation’s information infrastructure;
(2) as automation and digitization reach the healthcare industry, that industry will need to draw heavily on the expertise of researchers funded by the National Science Foundation for the collection, processing, and utilization of information;
(3) the National Science Foundation’s basic research, demonstrations, and curriculum development assistance are all required to help make sure the industry has the knowledge, procedures, and workforce necessary to take full advantage of advanced communications and information technology;
(4) the Bureau of Labor Statistics estimated that 136,000 Americans were employed in 2000 as information management professionals in the healthcare industry alone, with projected growth of 49 percent by 2010; and
SEC. 3. DEFINITIONS.
In this Act:
(3) INSTITUTION OF HIGHER EDUCATION- The term `institution of higher education’ has the meaning given that term in section 101 of the Higher Education Act of 1965 (20 U.S.C. 1001).
SEC. 4. NATIONAL SCIENCE FOUNDATION RESEARCH.
(a) Grants-
(1) IN GENERAL- The Director, in consultation with the heads of other Federal agencies as appropriate, shall award grants for basic research on innovative approaches to improve information systems. Research areas may include–
(2) MERIT REVIEW; COMPETITION- Grants shall be awarded under this section on a merit-reviewed, competitive basis.
(b) Informatics Research Centers-
(1) IN GENERAL- The Director, in consultation with the heads of other Federal agencies as appropriate, shall award multiyear grants, subject to the availability of appropriations, to institutions of higher education (or consortia thereof) to establish multidisciplinary Centers for Informatics Research. Institutions of higher education (or consortia thereof) receiving such grants may partner with one or more government laboratories, for-profit institutions, or non-profit institutions.
(2) MERIT REVIEW; COMPETITION- Grants shall be awarded under this subsection on a merit-reviewed, competitive basis.
(3) PURPOSE- The purpose of the Centers shall be to generate innovative approaches in information by conducting cutting-edge, multidisciplinary research, including in the research areas described in subsection (a)(1).
(4) APPLICATIONS- An institution of higher education (or a consortium thereof) seeking funding under this subsection shall submit an application to the Director at such time, in such manner, and containing such information as the Director may require. The application shall include, at a minimum, a description of–
(A) the research projects that will be undertaken by the Center and the contributions of each of the participating entities;
(B) how the Center will promote active collaboration among professionals from different disciplines, such as information technology specialists, health professionals, administrators, and social science researchers; and
(5) CRITERIA- In evaluating the applications submitted under paragraph (4), the Director shall consider, at a minimum–
(A) the ability of the applicant to generate innovative approaches to information and effectively carry out the research program;
(B) the experience of the applicant in conducting research in the information field, and the capacity of the applicant to foster new multidisciplinary collaborations;
(C) the capacity of the applicant to attract and provide adequate support for undergraduate and graduate students to pursue information research; and
(6) ANNUAL MEETING- The Director shall convene an annual meeting of the Centers in order to foster collaboration and communication between Center participants.
Continue Reading...SEC. 5. NATIONAL SCIENCE FOUNDATION INFORMATION PROGRAMS.
(a) Capacity Building Grants-
(1) IN GENERAL- The Director, in consultation with the heads of other Federal agencies as appropriate, shall establish a program to award grants to institutions of higher education (or consortia thereof) to establish or improve undergraduate and master’s degree information programs, to increase the number of students who pursue undergraduate or master’s degrees in information fields, to provide students with experience in government or industry related to their information studies, and, to the extent practicable, to do so using distance learning.
(2) MERIT REVIEW; COMPETITION- Grants shall be awarded under this subsection on a merit-reviewed, competitive basis.
(3) USE OF FUNDS- Grants awarded under this subsection shall be used for activities that enhance the ability of an institution of higher education (or consortium thereof) to provide high-quality information education, including certification and undergraduate and master’s degree programs, and to recruit and retain increased numbers of students to such programs. Activities may include–
(A) developing and revising curriculum to better prepare undergraduate and master’s degree students for careers in the information field;
(D) acquiring equipment necessary for student instruction in these programs, including the installation of testbed networks for student use;
(E) providing opportunities for faculty to work with State, local, or Federal Government agencies, private industry, and other academic institutions to develop new expertise or to formulate new information research directions;
(F) establishing collaborations with other academic institutions or departments that seek to establish, expand, or enhance these programs;
(G) establishing student internships for students in these programs at State, local, and Federal Government agencies or in private industry;
(H) establishing or enhancing bridge programs in information fields between community colleges and universities; and
(4) SELECTION PROCESS-
(A) APPLICATION- An institution of higher education (or a consortium thereof) seeking funding under this subsection shall submit an application to the Director at such time, in such manner, and with such contents as the Director may require. The application shall include, at a minimum–
(i) a description of the applicant’s relevant research and instructional capacity, and in the case of an application from a consortium of institutions of higher education, a description of the role that each member will play in implementing the proposal;
(ii) a comprehensive plan by which the institution or consortium will build instructional capacity in information fields;
(iii) a description of relevant collaborations with State, local, or Federal Government agencies or private industry that inform the instructional program;
(iv) a survey of the applicant’s historic student enrollment and placement data and a study of potential enrollment and placement for students enrolled in the proposed program; and
(5) ASSESSMENT REQUIRED- The Director, in consultation with the heads of other Federal agencies as appropriate, shall evaluate the program established under this subsection no later than 3 years after the establishment of the program. At a minimum, the Director shall evaluate the extent to which the grants have achieved their objectives of increasing the quality and quantity of students pursuing undergraduate or master’s degrees in information fields. The Director shall make this assessment publicly available.
(b) Scientific and Advanced Technology Act of 1992-
(1) GRANTS- The Director shall provide grants under the Scientific and Advanced Technology Act of 1992 for the purposes of section 3(a) and (b) of that Act, except that the activities supported pursuant to this subsection shall be limited to improving education in fields related to information.
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0 Are we looking to save jobs or create jobs?
Jan 17, 2009. Politics and HIT, Today.For many years, presidents and presidential candidates have touted the benefits of HIT. Health Information Technology, they’ve stated, can save lives, save money, improve medical care, allow physicians to make more money (???) as well as many other benefits.
Most recently, however, there seems to be an issue regarding whether or not HIT will save jobs or create jobs.
For instance, two recent articles, apparently quoting president-elect Obama appear to have contradictory information. From:http://abcnews.go.com/Health/President44/story?id=6606536&page=1 we see: “To improve the quality of our health care while lowering its cost, we will make the immediate investments necessary to ensure that, within five years, all of America’s medical records are computerized,” and “But it just won’t save billions of dollars and thousands of jobs; it will save lives by reducing the deadly but preventable medical errors that pervade our health-care system…”
My interpretation of that latter sentence is that it will ‘save thousands of jobs.’ From my perspective, that is not job creation.
However, from the same week we have an article in CNN from http://money.cnn.com/2009/01/12/technology/stimulus_health_care/index.htm
It states, in part:
“Doctors cannot spend hours and hours learning a new system,” said Castillo. “It needs to be a ubiquitous, ‘anytime, anywhere’ solution that has easily accessible data in a simple-to-use Web-based application.”
But highly skilled health information technology professionals are as rare as they come, and many IT workers will need to be trained as health technology experts.
Early government estimates showed about 212,000 jobs could be created from this program, but Brailer said there simply aren’t that many Americans who are qualified.”
Finally, we have: “In addition to connecting our libraries and schools to the Internet, we must also ensure that our hospitals are connected to each other through the Internet. That is why the economic recovery plan I’m proposing will help modernize our health care system – and that won’t just save jobs, it will save lives. We will make sure that every doctor’s office and hospital in this country is using cutting edge technology and electronic medical records so that we can cut red tape, prevent medical mistakes, and help save billions of dollars each year.” as quoted in http://www.politico.com/news/stories/1208/16258.html
So, we find that Health Information Technology, if implemented nationwide will both save jobs and create jobs. Note that in this context ‘saving jobs’ means that employed people will no longer be employed, thus saving money…
I, for one, am very anxious to see how this works out!
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1 Cost and Benefit – A Primer
Jan 15, 2009. Spotlight.Investing in an Electronic Medical Record (EMR) is a decision that most practices are putting off. Cost is one of the main reasons physicians do not adopt an EMR. EMR systems vary quite a bit in terms of cost, ranging from free systems all the way up to $100,000 enterprise-class systems.
Cost is an important factor. There is no reason to purchase a $100,000 system when a considerably more affordable system has all the features and customization that you need. Return on Investment (ROI) is a much more important consideration. ROI is a measure of the financial benefit you receive from an investment.
Most business owners know the importance of reinvesting in their business. The same is true for a medical practice. Does your practice have an X-ray or MRI machine? If so, think about how much additional revenue it provides. Instead of referring these procedures, you can perform them in-house and charge for them. Most equipment has an up-front cost. X-ray machines are an investment, because they will make money for you. Good investments will pay for themselves by bringing additional revenue to your practice.
EMRs are no different. While they do usually have some up-front cost, a good EMR will pay for itself in relatively short order by making your office more efficient, eliminating the cost of managing paper, and allowing you to bill higher codes through better documentation. Practices can spend several thousand dollars a year managing paper, including the cost of paper, toner, and the time staff spends scanning, faxing, or filing charts.
Many practices also bill at lower levels because their documentation is incomplete. The average difference between codes is about $30, and a good EMR should allow you to bill at least one level higher. $30 may not sound like much, but multiplied by the number of patients you see in a year, and that turns into about $225,000 of additional revenue in the first year, depending on how many patients you see on a daily basis.
Do not focus on cost when considering an EMR. ROI is a much more important consideration. Ask your EMR vendor to show you how their system will increase your revenue. Be sure to calculate how long it will take before the system pays for itself. Your EMR should pay for itself within one year.
Ryan Ricks
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Security Officer
www.XLEMR.com
