The Massachusetts Regional Extension Center has signed up more than 2,500 primary care providers to assist them in becoming meaningful users of health IT, making it the leader of the nation’s 62 centers in meeting its recruitment goal one year into the program.
After enrolling physicians, the next milestone will be for the extension centers to help physicians go live with certified electronic health records (EHRs) with electronic prescribing and quality reporting capabilities, according to a May 25 announcement from the Office of the National Coordinator for Health IT.
The health IT experience and skills of the extension center staff were crucial to reaching its goal so quickly, said Bethany Gilboard, director of health technologies for the Massachusetts eHealth Institute, which become the extension center in April 2010.
“We have three clinical relationship managers who are exceptional in working with the small physician practice,” she said.
The extension center program established by ONC is charged with helping 100,000 providers to overcome the hurdles of deploying certified EHRs and becoming meaningful users by 2012 to 2014.
Each extension center sets its own goal based on the number of providers that fit the description of a priority primary care provider. The Massachusetts center members include 45 percent of providers in small practices, 29 percent from community health centers, 16 percent from small practice consortia, and 10 percent from public hospitals.
The center has organized a roadmap that lays out the steps and expectations of physicians, consultants, and vendors to achieve meaningful use. If followed, the center guarantees that providers will qualify as meaningful users to be eligible for Medicare and Medicaid incentive payments from the Centers for Medicare and Medicaid Services, Gilboard said.
“We take a lot of the guesswork out for the small provider who has no one to turn to,” she said.
Provider members also have access to a special member portal of the extension center website where physicians can ask questions of their colleagues and learn from each other.
The Massachusetts center also systematically canvassed the state with emphasis on community hospitals with less capital resources to support their physicians in the transition to EHRs.
Staff contacted CIOs at all 72 hospitals in the state and found out if they had a strategy for establishing EHRs. They asked about the number of employed and independent primary care providers associated with the hospital. For those hospitals with a physician hospital organization or an independent practice association, the center offered a wholesale approach to membership for all primary care physicians. Alternatively, they supplied a draft letter that explained the benefits of the extension center and encouraged individual physicians to join.
Center staff also met with providers around the state at hospitals or medical society meetings through 25 educational summits and presentations. Once physicians enroll in the center, they’re invited to local meetings to share stories and hear about the experiences of local physicians who have already migrated to EHRs, known as meaningful use vanguards or MUVers.
This article was originally posted at http://ping.fm/45FMd
Patients more comfortable with doctors who use EHRs
Good news if you use an electronic health record (EHR) system—and a tip on how best to use it, courtesy of the Sage Healthcare Insights survey: Patients feel more comfortable with physicians who use an EHR system, and they believe that the information contained in the medical record is more accurate when they physically see the information being entered electronically.
The Sage Healthcare Division of software firm Sage North America conducted the survey among patients and physicians to determine attitudes regarding EHR adoption. “What we learned is patients like to see their verbatim information entered into the record as they said it, not as the doctor interpreted it,” says Betty Otter-Nickerson, president of the Sage Healthcare Division.
Other findings:
Overall, most physicians and patients agreed that medical records stored electronically will help improve patient care. Also, physicians and other clinicians who participated in the study said that EHRs are tool to help them perform their work more efficiently.
According to the survey, patients, on the other hand, increasingly expect their doctors to offer them access to EHRs and patient e-tools, and as a result, are encouraging their physicians to adopt more connected technologies, Otter-Nickerson says.
“Patients who participated in the survey said they had greater confidence in providers who use electronic records,” she says. “This suggests that there’s an opportunity for doctors to learn directly from their patients how to improve their practices and their patient relationships.”
The Sage Healthcare Insights study was conducted online in December 2010. The survey was sent to 7,738 physicians or other clinical users of a Sage product or service. The patient survey was sent to 18,000 healthcare consumers. Statistically, the sample size is large enough that the findings are applicable to the population.
This article was originally posted at http://www.modernmedicine.com/modernmedicine/InfoTech+Bulletin/Patients-more-comfortable-with-doctors-who-use-EHR/ArticleStandard/Article/detail/724096?contextCategoryId=44687
The Sage Healthcare Division of software firm Sage North America conducted the survey among patients and physicians to determine attitudes regarding EHR adoption. “What we learned is patients like to see their verbatim information entered into the record as they said it, not as the doctor interpreted it,” says Betty Otter-Nickerson, president of the Sage Healthcare Division.
Other findings:
- About 42% physicians use an EHR system to document patient care, and about one-third use an EHR during patient encounters.
- 62% of physicians and 81% of patients have positive perceptions of documenting patient care electronically.
- 45% of patients had a “very positive” perception of their physicians or clinicians documenting patient care with a computer or other electronic device.
- More than 60% of physicians believe that the best benefit to using EHR is the access they have to patient records in real time.
- Physicians also believe that the ability to seamlessly share information with other doctors, pharmacies, and payers are among the most important benefits.
- The majority of survey respondents agreed with the statement that EHR systems will help improve the quality of healthcare (78% of patients, 62% of physicians).
- Although both physicians and patients believe that EHRs will help improve the quality of healthcare, both groups have concerns about privacy and the security of EHRs (81% of patients, 62% of physicians).
- Given their use of and exposure to the security measures used to keep electronic medical records secure, physicians using EHRs have fewer concerns about the security of records.
- 47% of patients recall seeing their physicians or their nurse/assistants taking notes in a computer or other electronic device, whereas only 39% of patients recall seeing their physicians or their nurse/assistants taking notes directly into computers during treatment.
- Physicians and patients agreed on the benefits of using electronic devices to document patient care during an encounter.
- The most important benefits of EHR systems agreed on by the two groups: 1) Provides real-time doctor access to patient medical records and histories; 2) When appropriate, helps physicians securely and seamlessly share information with other doctors, pharmacies, and payers; 3) Helps doctors make good decisions about patient care, ultimately driving the quality of patient care.
Overall, most physicians and patients agreed that medical records stored electronically will help improve patient care. Also, physicians and other clinicians who participated in the study said that EHRs are tool to help them perform their work more efficiently.
According to the survey, patients, on the other hand, increasingly expect their doctors to offer them access to EHRs and patient e-tools, and as a result, are encouraging their physicians to adopt more connected technologies, Otter-Nickerson says.
“Patients who participated in the survey said they had greater confidence in providers who use electronic records,” she says. “This suggests that there’s an opportunity for doctors to learn directly from their patients how to improve their practices and their patient relationships.”
The Sage Healthcare Insights study was conducted online in December 2010. The survey was sent to 7,738 physicians or other clinical users of a Sage product or service. The patient survey was sent to 18,000 healthcare consumers. Statistically, the sample size is large enough that the findings are applicable to the population.
This article was originally posted at http://www.modernmedicine.com/modernmedicine/InfoTech+Bulletin/Patients-more-comfortable-with-doctors-who-use-EHR/ArticleStandard/Article/detail/724096?contextCategoryId=44687
Study: EMRs speed genetic health studies
Recruiting thousands of patients to collect health data for genetic clues to disease is expensive and time consuming. But that arduous process of collecting data for genetic studies could be faster and cheaper by instead mining patient data that already exists in electronic medical records, according to new Northwestern Medicine research.
In the study, researchers were able to cull patient information in electronic medical records from routine doctors' visits at five national sites that all used different brands of medical record software. The information allowed researchers to accurately identify patients with five kinds of diseases or health conditions – type 2 diabetes, dementia, peripheral arterial disease, cataracts and cardiac conduction.
"The hard part of doing genetic studies has been identifying enough people to get meaningful results," said lead investigator Abel Kho, MD, an assistant professor of medicine at Northwestern University Feinberg School of Medicine and a physician at Northwestern Memorial Hospital. "Now we've shown you can do it using data that's already been collected in electronic medical records and can rapidly generate large groups of patients."
The paper is published in Science Translational Medicine.
To identify the diseases, Kho and colleagues searched the records using a series of criteria such as medications, diagnoses and laboratory tests. They then tested their results against the gold standard – review by physicians. The physicians confirmed the results, Kho said. The electronic health records allowed researchers to identify patients' diseases with 73 to 98 percent accuracy.
The researchers also were able to reproduce previous genetic findings from prospective studies using the electronic medical records. The five institutions that participated in the study collected genetic samples for research. Patients agreed to the use of their records for studies.
Sequencing individuals' genomes is becoming faster and cheaper. It soon may be possible to include patients' genomes in their medical records, Kho noted. This would create a bountiful resource for genetic research.
"With permission from patients, you could search electronic health records at not just five sites but 25 or 100 different sites and identify 10,000 or 100,000 patients with diabetes, for example," Kho said.
The larger the group of patients for genetic studies, the better the ability to detect rarer affects of the genes and the more detailed genetic sequences that cause a person to develop a disease.
The study also showed across-the-board weaknesses in institutions' electronic medical records. The institutions didn't do a good job of capturing race and ethnicity, smoking status and family history, all which are important areas of study, Kho said. "It shows we need to focus our efforts to use electronic medical records more meaningfully," he added.
This article was originally posted at http://ping.fm/rcnib
In the study, researchers were able to cull patient information in electronic medical records from routine doctors' visits at five national sites that all used different brands of medical record software. The information allowed researchers to accurately identify patients with five kinds of diseases or health conditions – type 2 diabetes, dementia, peripheral arterial disease, cataracts and cardiac conduction.
"The hard part of doing genetic studies has been identifying enough people to get meaningful results," said lead investigator Abel Kho, MD, an assistant professor of medicine at Northwestern University Feinberg School of Medicine and a physician at Northwestern Memorial Hospital. "Now we've shown you can do it using data that's already been collected in electronic medical records and can rapidly generate large groups of patients."
The paper is published in Science Translational Medicine.
To identify the diseases, Kho and colleagues searched the records using a series of criteria such as medications, diagnoses and laboratory tests. They then tested their results against the gold standard – review by physicians. The physicians confirmed the results, Kho said. The electronic health records allowed researchers to identify patients' diseases with 73 to 98 percent accuracy.
The researchers also were able to reproduce previous genetic findings from prospective studies using the electronic medical records. The five institutions that participated in the study collected genetic samples for research. Patients agreed to the use of their records for studies.
Sequencing individuals' genomes is becoming faster and cheaper. It soon may be possible to include patients' genomes in their medical records, Kho noted. This would create a bountiful resource for genetic research.
"With permission from patients, you could search electronic health records at not just five sites but 25 or 100 different sites and identify 10,000 or 100,000 patients with diabetes, for example," Kho said.
The larger the group of patients for genetic studies, the better the ability to detect rarer affects of the genes and the more detailed genetic sequences that cause a person to develop a disease.
The study also showed across-the-board weaknesses in institutions' electronic medical records. The institutions didn't do a good job of capturing race and ethnicity, smoking status and family history, all which are important areas of study, Kho said. "It shows we need to focus our efforts to use electronic medical records more meaningfully," he added.
This article was originally posted at http://ping.fm/rcnib
CMS explains how to get paid EHR incentives
The Centers for Medicare and Medicaid Services will pay physicians four to eight weeks after they verify that they have satisfied conditions for meaningful use of electronic health records. That means that the soonest that CMS will issue incentives is in May.
Providers will not receive the incentive payments within that time frame, however, if they have not yet met the threshold of $24,000 for allowed charges in claims for covered services to Medicare beneficiaries during 2011, CMS said in an announcement April 28.
This article was originally posted at http://ping.fm/Dj8kR
Providers will not receive the incentive payments within that time frame, however, if they have not yet met the threshold of $24,000 for allowed charges in claims for covered services to Medicare beneficiaries during 2011, CMS said in an announcement April 28.
CMS launched meaningful use attestation on April 18. Once met, a qualifying physician will receive $18,000 in incentives for fulfilling the first stage of meaningful use.
The payments to physicians for the Medicare EHR Incentive Program are based on 75 percent of the estimated allowed charges for their covered during the entire payment year.
If a physician does not reach the threshold by the end of 2011, CMS said it expects to pay the incentive to the provider in March 2012, after allowing 60 days beyond the end of the 2011 calendar year for all pending claims to be processed.
CMS will use a payment file contractor to generate electronic payment of the inventives through the same bank account that providers receive payment for their Medicare claims, according to the announcement
[Editor's Desk: This Week in Government Health IT.]
To receive the maximum amount of $44,000 in incentives over the five years of the program, physicians must begin participating in 2011 or 2012. Providers who supply services in a "health professional shortage area" may receive additional incentives, CMS said.The bonus will be separate lump-sum payments within 120 days after the end of the year.
EHR incentives for hospitals and cirtical access hospitals start with a $2 million base payment. They will receive initial and final payments.
States manage the Medicaid EHR Incentive Program, in which physicians can receive up to $63,750 over six years. Medicaid hospitals also begin with a $2 million base payment. Timing of the states’ payment of incentives varies according to their program, CMS said.
This article was originally posted at http://ping.fm/Dj8kR
GAO says VA not transparent enough
The Veterans Administration’s new resource allocation process uses a standardized electronic model, but the transparency of networks' decisions for allocating resources to medical centers is limited, a new GAO report concludes.
[Editor's Desk: This Week in Government Health IT.]
In its April 29 report, GAO recommends that the VA require networks to provide rationales for all adjustments made to allocations proposed by VA's resource allocation model, and that it develop written policies to document practices for monitoring resources. The VA concurred with these recommendations.
The new process involves three steps:
- First, VA headquarters proposes medical center allocation amounts to networks using a standardized resource allocation model. The model includes a standardized measure of workload that recognizes the varying costs and levels of resource intensity associated with providing care for each patient at each medical center.
- Second, network officials review the proposed amounts and have the flexibility to adjust them if they believe that certain medical centers' resource needs are not appropriately accounted for in the model.
- Third, networks report final medical center allocation amounts to VA headquarters and any adjustments made to the allocation amounts proposed by the model.
VA headquarters did not ask networks to report reasons for each adjustment made to allocation amounts; networks reported reasons for some adjustments, but not for others.
VA officials said that the new network resource allocation process was not intended to be used to question networks' decision making, but to increase the transparency of networks' allocation decisions to VA headquarters while maintaining network flexibility.
However, absent rationales from networks on all adjustments made to medical center allocation amounts, transparency for decisions made through the allocation process is limited. Furthermore, understanding why networks make adjustments is key in determining if any modifications to the model are needed for subsequent years.
VA officials told GAO that they intend to conduct annual assessments of the new resource allocation process, including a review of adjustments to the model, to identify areas for improvement.
[See also: VA, DOD to incorporate open source in EHR.]
VA centrally monitors the resources networks have allocated to medical centers to ensure spending does not exceed allocations, but does not have written policies documenting these practices for monitoring resources. VA monitors resources through two primary practices – automated controls in its financial management system and regular reviews of network spending.
Specifically, VA's financial management system electronically tracks the amount of resources that networks and medical centers have available--the resources allocated, less the resources already spent--and prevents medical centers from spending more than what they have available by rejecting spending requests in excess of available resources.
In addition, each month VA headquarters officials compare each network's spending with what the network planned to spend and determine whether spending is on target, and whether any differences from the plan are significant.
However, VA headquarters does not have written policies documenting the agency's practices for monitoring resources, which is not consistent with federal internal control standards. These standards state that internal controls should be documented, and all documentation should be properly managed, maintained, and readily available for examination.
Without written policies, there is an increased risk of inconsistent monitoring of VA network and medical center resources.
This article was originally posted at http://ping.fm/UT5ro
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