Archive for February, 2009
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5 What the HITECH Act Means to Physicians
Feb 27, 2009. Politics and HIT.On February 17, 2009 the Economic Stimulus Bill also known as the American Recovery and Reinvestment Act 2009 was finalized and signed by President Obama. A large portion of the stimulus focuses specifically on the improvements within the Healthcare Industry. This section of the stimulus is known as the Health Information Technology for Economic and Clinical Health Act (HITECH Act) and discusses the improvement of Healthcare Quality, Safety, and Efficiency; Testing of Health Information Technology; Grants and Loans Funding; and Privacy.
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2 National Online Health Records Detrimental to Privacy
Feb 24, 2009. Government Initiatives.2009 is a year of hope and change. However, it is not certain that change will be positive when rushed through congress at break-neck speed. The economic stimulus bill that President Obama just signed includes legislation that will establish a national computerized medical records database that will contain data on every citizen. In addition, the legislation will force physicians to adopt electronic medical records (EMRs) that meet government standards and specifications.
There are three main problems with this new legislation. First, it eliminates patient choice regarding disclosure of their medical records. Second, it creates a high-value target for online criminals. Third, it eliminates freedom of choice for physicians.
A national database containing data on “every American” by definition proscribes patient choice. Although the legislation states participation is voluntary, it does not contain any measures for opting out of the system. Furthermore, the database will be used for biosurveillance, public health, as well as research purposes. It is unclear what “biosurveillance” means at this time. However, it is clear that any citizen in this data base will have no control over their records.
Online databases of medical information have traditionally been high-value targets for e-criminals. Medical databases are desirable because they usually contain the information necessary to perpetrate identity theft. Additionally, there are many recorded incidents of hospital record systems made available on the internet through poor server configuration or administrative error. The government has a lackluster history regarding computer security. The Federal Information Security Management Act (FISMA) was enacted to improve security, but its success has been marginal.
The government will use Medicare and Medicaid reimbursements to force physicians to adopt an EMR that meets government specifications. Although we do not know what those specifications will involve, they will probably be of a “one size fits none” nature. Specifications designed by committees tend to change rapidly and be unnecessarily complex. Implementing medical records is a difficult task without being forced to adopt an overly expensive and complex system.
While there is certainly a need to encourage physicians to adopt EMRs, the current strategy of implementation through legislation has many problems including patient privacy, security of medical information, and freedom of choice.
Read the article.
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Ryan Ricks
Security Officer
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0 Simplicity is Key
Feb 18, 2009. Today.Many physicians dread making a touch decision. What electronic medical record (EMR) should they adopt, and when should they adopt it? No longer a matter of choice, the federal government instituted a deadline of 2014 for rolling out national medical records.
Selecting an EMR does not have to be a stressful process. Simplicity is the key to selecting an EMR. Simple systems are easy to install, easy to learn, and easy to use. The problem is that many physicians focus only on price. There are many important factors to considering an EMR, such as price, features, return on investment, and associated hardware costs.
Simplicity is much more important than price. It doesn’t matter whether your EMR costs $100,000 or $995, if it is complex and difficult, neither you nor your staff will use it. The money you spent and the time you invested in learning the new system will be wasted. Many physicians have heard horror stories from their colleagues regarding this very point. No one wants to be stuck with a complicated system that’s difficult to learn and impossible to use.
A simple EMR is easy to install. You should avoid complex EMRs that require a substantial hardware investment. Unless you have a large office with a lot of staff, your EMR should run on the computers you already own. A simple EMR can run on the computers you already own.
A simple EMR is easy to learn. Training time is one of the most significant costs of EMR implementation. Your vendor may charge you for training time. In addition, your practice will lose revenue because every hour spent training is one hour you are not seeing patients. A simple EMR will minimize training time.
A simple EMR is easy to use. Many EMRs have complicated screens that require you to navigate through many pages just to see one patient. Systems can also be overloaded with unnecessary features that confuse you and your staff. A simple EMR will make it easy to do your job.
Physicians can remove much of the stress out of the selection process by focusing on simple EMRs. If it takes a vendor more than about five minutes to demonstrate a system, or if a system doesn’t naturally “make sense,” then it is probably not a simple system. Remember that simple EMRs are easy to install, easy to learn, and easy to use.
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Ryan Ricks Security Officer
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4 Is CCHIT the Answer?
Feb 12, 2009. Insight.The Commission for Healthcare Information Technology (CCHIT) has come a long way since its inception in 2004. It is evident by the Obama Administration and the American Recovery and Reinvestment Act that $20 billion will be invested towards electronic health records, specifically ones that are ‘certified.’ When one hears of a ‘certified EHR,’ one assumes that it means a CCHIT Certified® EHR System. Is this a fair assumption? Why should physicians only benefit if the purchased EHR is CCHIT Certified® ? I believe that there are several ambiguities within the Act that need clarification before physicians misconstrue statements within the Act.
To begin with, CCHIT is a private, non-profit organization whose mission is to ‘accelerate the adoption of robust, interoperable health information technology by creating a credible efficient certification process.’ Although it is a non-profit organization, there’s a hefty price tag for EHR Companies to become certified. Several of the smaller companies do not have the capital investment to even apply for the certification. This will result in several smaller companies losing their status and more frequently declaring bankruptcy.
In addition, several companies will not be able to become certified because they may not meet all of the 250 criteria. So what about Mental and Behavioral Health Electronic Medical Records? There are specialty specific EHR Companies that have a solid reputation, however, may soon be frowned upon because of the lack of the CCHIT certification. So, how does this work then?
Specialty specific physicians will want to purchase a system that focuses primarily on their specialty, with all of the features that they may need. Does this mean that these physicians who decide to not purchase a ‘certified EHR’ will not be reimbursed?
Why should people within the medical community suffer financially because they want to implement the most appropriate EHR for them? I believe that this will be a growing concern within the healthcare industry that needs to be addressed immediately.
Thoughts anyone?
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3 EMRConsultant.com's Analysis of the Current Environment Concerning Promoting the Nationwide Adoption of an Interconnected Electronic Health Record Network
Feb 11, 2009. Politics and HIT.
By Eric S. Fishman, MD, February 9, 2009
While the United States spends more money per citizen on its healthcare than any other country, and while its physicians are extraordinarily well trained and capable, it is widely acknowledged that the quality of the healthcare provided in the United States is inferior to that of many other countries. It is furthermore assumed, and we believe correctly, that the utilization of a nationwide, connected healthcare information infrastructure will both significantly reduce costs as well as drastically improve patient safety. The American Recovery and Reinvestment Act of 2009 acknowledges this and offers $20 billion to promote this end result.While the final rules have not yet been published, the following information should provide a guideline improving the potential for you to qualify for the maximum amount of reimbursement / compensation from the implementation of this Act. Financial benefits to physicians can occur through reimbursement of purchase costs, low interest loans for purchase costs, and enhanced payments for caring for Medicare and Medicaid patients.
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0 Pending Healthcare Information Technology Legislation
Feb 7, 2009. Politics and HIT.I find myself constantly looking for the original source material for the various bills pending in Congress.
Here are a few links to these bills:
Senate Version January 27th, 2009: http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:s336pcs.txt.pdf
Senate Version January 30th, 2009: http://thomas.loc.gov/cgi-bin/query/C?c111:./temp/~c111qh9wQt
Senate Version – Full 736 pages, in PDF format, January 30th, 2009: http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h1as.txt.pdf
House Version January 15th, 2009 http://appropriations.house.gov/pdf/RecoveryBill01-15-09.pdf
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2 Research? Seems that 80,000 doctors may feel differently
Feb 2, 2009. Dragon Medical, Insight, Politics and HIT.If you ask Nuance about Dragon Medical, they will proudly state that it is being used by more physicians than any individual EMR/EHR.
Their published statistics indicate that there are currently 80,000 phyisican users of Dragon Medical speech recognition (aka voice recognition) software.
So, needless to say, I was more than a little surprised to find one small comment about it in the 647 page American Recovery and Reinvestment Act of 2009.
But yes, there it is, on page 436, we find the following:
(4) RESEARCH AREAS.—Research areas may include—
(A) interfaces between human information and communications technology systems;
(B) voice-recognition systems;It certainly seems to me that voice-recognition systems should be considered more than ‘Research’!
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