New Research Provides First Evidence

By Sheri Porter - 12/23/200

Physicians who say they can’t afford to purchase an electronic health record, or EHR, system may want to evaluate new research that suggests physician practices that use EHRs have fewer paid malpractice claims.

The study, Electronic Health Records and Malpractice Claims in Office Practice, was published in the Nov. 24 Archives of Internal Medicine. Researchers looked at 10 years of data on paid malpractice settlements across the state of Massachusetts.

Study results show that of the 1,140 physicians who responded, 33.2 percent use EHRs in their practices. Of these respondents, 6.1 percent had a record of paid malpractice claims compared with 10.8 percent of physicians who did not use an EHR.

Lead study author Steven Simon, M.D., M.P.H., associate professor in the department of ambulatory care and prevention at Harvard Medical School and Harvard Pilgrim Health Care in Boston, said in an interview that the research filled a void.

“Studies to date have failed to show convincingly that electronic health record adoption alone simply improves quality of care,” said Simon. We were trying to “find additional support for what most clinicians who have EHRs feel and believe … that having such a system does help them provide higher quality and safer health care for their patients.”

Simon said his was the first published study to look at EHR adoption and use alongside paid malpractice claims.

Study Implications

The researchers said in the study that the results should be considered preliminary, but they did note several ways the research could directly affect physician practices. For instance, if the results are replicated in future studies,

· physicians could view the prospect of fewer malpractice claims as significant enough to “tip the scale” in favor of EHR implementation;

· malpractice liability carriers could lower physician malpractice premiums for physicians using EHRs; and

· federal and private payers could allocate more funds to help physicians buy EHRs.

“My hope would be that the health insurance community increasingly recognizes the value to them of their physicians and practices having these systems,” said Simon. “There will be a lot of research in the next handful of years, and I’m actually very hopeful and confident that our results will be borne out in other studies.”

Consistency Across Specialties

Simon said he was surprised that the study results were consistent across high-risk and low-risk medical specialties. Although the study data are sparse, they show that, regardless of specialty, physicians in the study were half as likely to have paid a malpractice claim if they had an EHR.

“I would have thought that specialists in primary care might get more benefit from the EHR,” than subspecialists, such as surgeons, said Simon. That’s because when primary care physicians make medical errors, they’re usually related to the cognitive process.

For instance, family physicians need to prescribe appropriately, remember to do the right test and make sure they follow up on abnormalities. All of those are “amenable to the EHR helping,” because the EHR provides prompts and reflags, said Simon.

On the other hand, surgeons would seemingly have more procedural types of medical errors less affected by the presence of an EHR, he added.

Simon called it “a little bit of a stretch beyond our data” but said the study results suggest that “what’s good for the family physicians and the internists seems to be good for the surgeons, and should be good, at least theoretically, for the psychiatrists and for other clinicians as well.”

EHR Functionality

To test the role of an EHR’s functionality, Simon and his fellow researchers split participants into two groups and labeled them “high users” and “low users.”

Physicians in the first group used 50 percent or more of their EHRs’ available functions most or all of the time. Low users used less than 50 percent of their systems’ available functions most or all of the time.

Simon said his hypothesis — that high users would get more benefit from the EHR — was correct. Results showed that about 6 percent of high users had paid malpractice claims in the past 10 years compared with 12 percent of low users.

The results drive home the argument that purchasing and installing an EHR system is not enough, said Simon.

“In order to improve quality and safety, an EHR really needs to have robust features, like clinical decision support, electronic prescribing, order entry and the ability to communicate with other clinicians,” said Simon. And physicians need to learn how to use all of the functions, he added.

The Webinar will take place at: http://www.pqrimadeeasy.com/webinar.aspx on the following dates (all times are EST):

• 11/20 - 12:15PM
• 11/25 - 6:15PM
• 12/2 - 12:15PM
• 12/4 - 6:15PM
• 12/9 - 12:15PM
• 12/11 - 6:15PM

Each Webinar will review the alternative ways for medical providers to enjoy the CMS PQRI Bonuses in 2008. It will explore the methods, workflows, risks and will give simple tips and tricks to gain the 2008 bonus within 3 days or less. The webinar will also elaborate on the new 2009 measures.

Some of the Webinar sessions will host relevant professionals from the electronic healthcare record (EHR) arena, such as George S. Blumenthal, PHD - President of Park Avenue Medical Data Systems, HIMSS committee member; Talor Sax - VP Business Development at eWaveMD, a Software-as-a-Service (SaaS) solutions developer for the healthcare industry; and physicians who have already taken the necessary steps in order to win the 2008’s PQRI bonus payment.

The CMS 2008 PQRI Webinar is sponsored and delivered by Park Avenue Medical Data Systems (PAMDS) as a free service, and will not include commercials or marketing materials.

For more information about PQRI, please visit the PQRI Made Easy(TM) website: http://www.pqrimadeeasy.com

Quotations includes Yahoo Finance, AOL, FORBES, Healthcare Industry Today, Reuters and others.

ITWeb :Hospital RFID use raises concerns

Cloud Computing Journal

New York, NY – November,2008. Park Avenue Medical Data Systems (PAMDS), a leading provider of software solutions for the electronic healthcare record (EHR) arena, announces the launch of PQRI Made Easy™: a free Software-as-a-Service product (SaaS) that enables office-based physicians, hospitals for outpatient services, and specialized medical facilities to earn pay-for-performance bonus payments from Medicare pursuant to the CMS Physician Quality Reporting Initiative (PQRI). One can register for free and start using the Web-based software at:

http://www.pqrimadeeasy.com.

PQRI Made Easy™:

1) Takes only minutes a day

2) Is totally free with no strings attached

3) Providers who participated completed their 2008 reporting in 3 days

4) Works equally well in a paper-based workplace or a fully automated office

5) Will facilitate HEDIS reports for private payor P4P initiatives.

PQRI Made Easy™ is a free pay-for-performance reporting product with no strings attached (no software licensing fee, hidden costs, advertisements, trial periods, etc.) and will remain free of charge. Medical practices may estimate the relationship between their effort and their CMS bonus potential and realize how much money they will earn with the PQRI calculator, found at:

http://www.pqrimadeeasy.com/calculator.aspx.

According to George S. Blumenthal, Park Avenue Medical Data Systems President, there is still time to submit Medicare PQRI reports for patients seen until December 31st of 2008 and collect the CMS bonus. Moreover, he believes that it is imperative that every healthcare provider should begin to prepare now for 2009 when the PQRI bonus increases to 2% on all Part B Fee-for-Service reimbursements. Additionally, eligible professionals can earn a 2% bonus for e-prescribing in 2009.

The underlying information technology for PQRI Made Easy™ has processed BILLIONS of healthcare transactions in Israel. Every doctor in Israel utilizes an electronic healthcare record keeping system. Every citizen can access their complete medical records over the Internet.

PQRI Made Easy™ is the first product in a suite of highly-secured eHealth Made Easy™ EHR products scheduled for introduction in 2009. The eHealth Made Easy™ suite of products have been constructed with special emphasis on simplicity – they are easy to learn, have a friendly user interface, fit right into existing workflows, and only require an Internet connected PC with the Internet Explorer 7 web browser.

PQRI Made Easy™ and eHealth Made Easy™ are products and trademarks of Park Avenue Medical Data Systems (PAMDS).

For more information, please visit the PQRI Made Easy™ website:

http://www.pqrimadeeasy.com

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Contact:
Park Avenue Medical Data Systems LLC
599 Lexington Avenue, 19th Floor
New York, NY 10022
Tel. +1-212-400-3281
Fax +1-212-400-3293
email: info@parkmedical.info

]]> http://pqrimadeeasy.com/Blog/?feed=rss2&p=88 http://pqrimadeeasy.com/Blog/?p=71 http://pqrimadeeasy.com/Blog/?p=71#comments Wed, 22 Oct 2008 16:58:39 +0000 cindy http://pqrimadeeasy.com/Blog/?p=71 A Clinician’s Guide to Electronic Prescribing

By Bernie Monegain, Editor 10/07/08
Healthcare IT News

ith the first phase of Medicare’s mandate for e-prescribing rolling out in January, healthcare IT leaders, led by Health and Human Services Secretary Michael Leavitt, gathered Tuesday in Boston to jumpstart the initiative.

“One of the beauties of the system is that it will reduce the number of medical mistakes … and tragic results,” Leavitt said at the National E-prescribing Conference.

We know it saves lives, we know it saves money, and it’s time to implement it.”

Leavitt tied the nation’s current economic crisis to the rising costs of healthcare and noted that going electronic with prescriptions helps provide cost-savings for patients, doctors and the entire healthcare system.

“It’s an economic imperative in this country,” he said.

In January, The Centers for Medicare & Medicaid Services will begin its five-year program providing incentive payments to eligible professionals who adopt e-prescribing. The payments will be equal to 2 percent of the physicians’ Medicare-allowed charges.

The program includes penalties for those who do not make the switch from paper - 1 percent of their Medicare-allowed charges beginning in 2012 and 2 percent beginning in 2014.

The Medicare Improvements for Patients and Providers Act of 2008 established the five-year program of incentive payments to eligible professionals who are “successful electronic prescribers.”

According to the Institute of Medicine, more than 1.5 million Americans are injured each year by drug errors, causing an estimated 7,000 deaths. Other studies show that pharmacists make more than 150 million phone calls a year to clarify illegible prescriptions with doctors.

Medicare is expected to save up to $156 million over five years by preventing some 530,000 adverse drug events, Leavitt said.

Leavitt delivered his comments at the second day of a two-day National E-Prescribing Conference organized by CMS in Boston. Among the healthcare IT leaders in attendance were Kerry Weems, acting administrator of the CMS; Sen. John Kerry, (D-Mass.); Newt Gingrich, founder of the Center for Health Transformation; and David Brailer, MD, founder and chairman of Health Evolution Partners and the  former national coordinator for healthcare information technology.

]]> http://pqrimadeeasy.com/Blog/?feed=rss2&p=69 http://pqrimadeeasy.com/Blog/?p=62 http://pqrimadeeasy.com/Blog/?p=62#comments Mon, 06 Oct 2008 14:36:33 +0000 cindy http://pqrimadeeasy.com/Blog/?p=62 MedPage Today

Physician Payments May Take Hit as Medicaid Enrollment Swells in Declining Economy

By Emily P. Walker, Washington Correspondent, MedPage Today
Published: September 29, 2008

ASHINGTON, Sept. 29 — Medicaid payments to physicians may be trimmed next year as states seek to offset the cost of growing enrollment in the programs, according to the authors of a Kaiser Family Foundation Survey.

The survey found that Medicaid enrollment rates rose by 2.1% in 2008, after declining slightly in 2007. The survey attributed the rise in enrollment to patients losing their jobs and their employer-based coverage, which drove them into Medicaid.

“We’re just beginning to see the impact of the economic slowdown, as growing Medicaid enrollment and shrinking revenues pose new threats for health coverage,” said Diane Rowland, executive vice- president of the Kaiser Family Foundation.

According to an earlier Kaiser report, every 1% increase in the national unemployment rate translates to one million more enrollees in Medicaid and the State Children’s Health Insurance Program (SCHIP) and a $1.4 billion increase in how much states must contribute to run their Medicaid programs.

Meanwhile, states boosted outreach efforts and simplified enrollment procedures in 2008 to bring more uninsured people into Medicaid, which covers 29.5 million children, 15 million adults, and 14 million elderly people and people with disabilities.

Physician reimbursement is a likely area for cost savings, said Vernon K. Smith, Ph.D., a principal at Health Management Associates and author of the report called “Headed for a Crunch: An Update on Medicaid Spending, Coverage and Policy Heading into an Economic Downturn.”

“No states like to cut provider payments,” Dr. Smith said. “But it is perhaps one of the first places states would turn to because it is a real savings.”

He said other cost-cutting measures, such as raising requirements to drive down enrollment, might take longer to generate savings.

Today’s report was the Kaiser Family Foundation’s eighth annual survey to poll state Medicaid directors in all 50 states and the District of Columbia about trends in spending and other policy issues. The telephone and written surveys were conducted in July and August of 2008.

In addition to finding that Medicaid enrollment rates increased in 2008, the study showed that for 2009, states are predicted to see enrollment rates grow by 3.5%. The average rate of enrollment increase is 7.1%, Dr. Smith said.

Spending for the programs increased by 5.3% in 2008, and Medicaid directors predict a 5.8% spending growth for 2009.

One state Medicaid administrator agreed that as Congress is grappling with the possibility of shelling out billions to bail out the financial industry, chances for increases in healthcare funding are slim.

“The $700 billion has sucked all the air out of Congress,” said David Parrella, director of Medical Care Administration in Connecticut.

Because states must balance their budgets each year, most have surpluses that they can use to fund the program, but those rainy-day funds are already depleted in some states, like California, and the study found that 30 states face budget shortfalls for 2009.

The survey also found:

• 36 states said access to specialty care was a major problem, 39 states said beneficiaries were having trouble accessing specialty care, and 17 states reported problems with access to primary care.
• In 2008, 42 states took action to expand long-term care services and 41 states planned to expand their long-term care services in 2009.
• Three-quarters of states used some form of pay-for-performance incentives in fiscal 2009, compared with fewer than half of all states using a pay-for-performance arrangement three years earlier.
• Some states reported limited expanding coverage to children because of the uncertainty of SCHIP, which Congress has only reauthorized through March 2009.

The report came days after the House passed an appropriations bill that would temporarily increase the rate at which the federal government matches state Medicaid funds. The Senate version of the bill, which would have also increased NIH funding by 1.6 billion, stalled when a vote to proceed on debating the House version failed.

Nearly 30 Leading Healthcare Organizations Commit to Using
Newly-Released CORE Phase II Rules

Washington, D.C. (Sept. 15, 2008) – CAQH announced today that for the first-time providers will be able to receive consistent electronic information about patient deductible balances from potentially any health plan at the point of care.

This achievement is the result of voluntary business rules developed during the second phase of activities conducted by the CAQH Committee on Operating Rules for Information Exchange (CORE), a collaborative healthcare industry initiative.

CAQH, a nonprofit alliance of health plans and trade associations working to streamline healthcare administration, launched the multi-phase program in 2005. CORE is focused on improving provider access to electronic patient administrative and payer information before or at the time of service using any technology they choose. The CORE rules build upon national standards, such as HIPAA. Each phase expands the pool of available data and augments the functional requirements to exchange it electronically.

“Today’s announcement further demonstrates that CORE is transforming the way our industry communicates,” said Ronald A. Williams, CAQH chairman of the board and chairman and CEO of Aetna. “With the Phase II rules now in place and work begun on Phase III, CORE is effectively achieving its mission to create an all-payer approach to streamlined administrative data exchange.”

Through CORE, CAQH has brought together more than 100 healthcare industry stakeholders as partners in rules development. Health plans participating on the committee cover more than 130 million lives or more than 75 percent of the commercially insured plus Medicare and state-based Medicaid beneficiaries.

The Phase II rules also cover requirements for electronic connectivity, patient identification, claims status and reporting of patient financial responsibility for an increased number of service codes included in the HIPAA standards. CORE’s second set of rules builds on the rules created by the initiative during its Phase I efforts, completed in 2006. Both phases are advancing health plan-provider system interoperability.

“CAQH CORE standards reduce costs and enhance efficiency by connecting payers, providers and patients with the data they need to support the administration of healthcare,” said John Halamka, Healthcare Information Technology Standards Panel (HITSP) Chairman, and Chief Information Officer, Harvard Medical School and Beth Israel Deaconess Medical Center.

CAQH also announced that more than 25 leading health plans, large provider groups and technology vendors are committed to completing Phase II rules certification testing by the end of 2009.  These stakeholders – currently certified as complying with the CORE Phase I rules — include: Aetna Inc.; AultCare Corporation; WellPoint, Inc. and its 14 BCBS-licensed subsidiaries; Mayo Clinic; Montefiore Medical Center; ACS EDI Gateway, Inc.; Availity, LLC; Emdeon Business Services; HMS; MedAvant Healthcare Solutions; MedData; NaviMedix, Inc.; Passport Health Communications; Post-N-Track; RelayHealth; Siemens Medical Solutions; athenahealth, Inc.; CSC Consulting, Inc.; Emerging Health Information Technology; GE Healthcare; Medical Informatics Engineering, Inc.; NoMoreClipboard.com; The SSI Group, Inc.; and VisionShare, Inc.

Harvard Pilgrim Health Care and Ingenix have committed to achieve CORE Phase I and II rules certification by the end of next year.

BlueCross BlueShield of Tennessee; Health Net, Inc.; Humana Inc. and SureScripts-RxHub will become CORE Phase II rules certified by the end of the first quarter in 2010. Entities must complete a testing process to confirm that their systems and/or products comply with the CORE rules. Phase I certification is required prior to completing Phase II certification. The CORE rules now allow for entities to complete Phase I and II certification testing during a single, integrated process. More than 20 healthcare associations, accrediting bodies, networks and businesses have committed to endorsing the CORE Phase II rules.

The Blue Cross and Blue Shield Association expressed its support for the initiative with the following statement: “BCBSA is pleased to participate in CAQH CORE’s efforts to streamline electronic eligibility. Simplifying provider access to patient insurance coverage information is critical and the Blues believe that CORE is a key initiative to bring the industry together for collaboration and consensus building.”

CORE is currently determining the scope of issues it will create rules for during its third phase. Issues under consideration include determining in- or out-of-network status of a provider, alternative search requirements for eligibility transactions when some member ID information is missing, coordination of benefits, claims attachments and harmonizing CORE with other industry standardization efforts.

200808_ehrglobalperspective_whitepaper

Today, after 20 years of health IT development, virtually every person in the State of Israel, whether they are a citizen or a resident, has an electronic healthcare record (EHR).

Israel has a population of more than seven million people, which is larger than 38 of the States in the United States.  The life expectancy in Israel is 82 years of age for women and 78 years of age for men. Israel spends 8 percent of its GDP on healthcare.  Everyone has basic coverage, which is offered through one of four HMO’s.  People can also purchase additional coverage.

In Israel, all healthcare providers utilize Electronic Medical Record Systems (EMRs) that are tied into the main record keeping systems of the HMO’s. A doctor may work on behalf of any, or all, of the HMO’s. Every person in Israel can access their complete healthcare record over the Internet; and in many cases, through free-standing kiosks.  Traditional telemedicine; such is teleradiology, is in wide-spread use and telemonitoring is being rapidly deployed for such applications as “Virtual Nursing Homes”.

The Israeli people are particularly mindful of the security and safety of their healthcare information.  Medical privacy has evolved in a multitude of ways; i.e., knowledge gained by participating in the Israeli defense forces,  the cumulative knowledge of process development over the past 20 years and a culture attuned to safety and security.

The USA, as well as other countries throughout the world, can easily adopt the IT knowledge gained from Israel’s healthcare system for improving the level of care and for reducing redundant expenditures.

The prowess of Israeli information technologies is denoted by extensive research facilities of such companies as Intel, Microsoft, Oracle, Motorola and Hewlett-Packard.  Additionally, firewall technology and AOL instant messaging were developed in Israel.

Attached is a short clip regarding Israel’s High-Tech industry.  The video clip can be downloaded from: http://www.export.gov.il/NewsHTML/life%20science/Invest-in-Israel.wmv