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Hello T1, I have seen that before but I always enjoy that & good article reads. Thanks & have a good day.
Damn, when I told ya 2 tell'em... you took me literally! Go get'em my friend & Stay Safe in the process.
You tell'em 3F, call me if you need help. lol...
Pilot, I'm following up IVB, but I agree everyone is perceiving this differently. I also know you have to do what is best for you & your family. Speaking of which you haven't shared anything with us in a year or more about how your child (forgot boy or girl, I think a boy) is doing? None the less I wish you the best & God's speed. FJ74 isn't the only 1 who had a huge Escavator & new how to use it.
God Bless you & the family,
Tom aka: Tbone
Has anyone noticed the rise WebMD "WBMD" stock has risen since the announcement of the MMRF PR?
Well, well, well 3F, glad you made it to the dinner table. Foods already staring to get cold. But it sounds like you agree that 1 + 1 has to equal 2. My gun"s" are cocked & loaded.
I welcome & respect your input, but you do know I really only respond to you so I can say howdy, howdy! to that lovely lady you have?
Howdy, Howdy, Lovely Lady!!! lol...
Got your PM, thank you. But I am not sure I am understanding what you are saying to me. I think I do but just not sure. Would you please explain or expand? Thanks, EZ!
Morning Blue Steel, like Poison Pill I think you might be on 2 something. Like magic why your watching here the work is being done over there. It doesn't add correctly. Dropping this suit with the option to file again & still pursuing the suit with Jardogs a subsidiary of Allscripts. Something is Up!
1 + 1 = 2 has 2, 3 just does not work!
Helloooo & good morning FJ74, damn good post, excellent. But you make sure that escavator of yours is on top of them court cases counsler. lol...
Good Morn-N-Ing MMRF Boardees, this is a good read & I found it to be 1 more reason why when it is said & done... the patient will have to control their OWN PHR. Also click on the link & at the end of the article are several other links leading to talks about MU "Meaningful Use" & the months to come.
The Promise Of Medicaid Health Home Technology
Jun 06, 2013 06:49 am | By: John
The following is a guest post by Ms. Lori Evans Bernstein, President of GSI Health.
The Affordable Care Act of 2010 introduced the health care industry to Medicaid Health Homes, an optional Medicaid State Plan benefit program designed to improve Medicaid care coordination and delivery for patients with two or more chronic conditions. Of course, like so many aspects of the new legislation, this provision created at least as many questions as it has answered. Most importantly, what kind of technology will Medicaid Health Homes require to ensure successful implementation?
In order to answer that question, you need look no further than the primary benefits this new care model offers:
Collaboration
Medicaid Health Homes are expected to offer “whole-person” care. That means breaking down the silos that have traditionally separated care providers into categories such as medical, social and behavioral and inpatient, outpatient and post-acute. This is no easy task.
Medicaid Health Home technology needs to offer care providers the tools and resources required to bridge the information and collaboration gap those traditional care silos have created. Individual care providers require a flexible solution to share patient information and collaborate on their care effectively and efficiently among multiple providers and across the care continuum.
In short, Medicaid Health Homes and Accountable Care Organizations (ACOs) need a health IT platform capable of unifying not only data from different sources but also providers in different settings and distributing relevant patient information in a precision-targeted manner.
Accountability
Delivering on the promise of “whole-person” care is not just about connecting systems. It’s about connecting people and creating a clear path to accountability. Medicaid Health Home technology needs to connect patients with the integrated network of care providers required to address their unique individual needs. In order to achieve that mission, care providers require a health IT solution that goes beyond today’s electronic health record systems used “inside the four walls” capable of connecting them seamlessly with the colleagues and fellow professionals required to establish a complete picture of each patient’s care history.
With so many different professions and providers collaborating on patient care, creating a comprehensive workflow is essential if Medicaid Health Homes are to be successful. Analyzing data and reporting outcomes and predicting risk and events are necessary, but not sufficient to improve outcomes and reduce costs. The tools enabling collaboration on patient care that, for example, alert the provider to an ED admission, manage referrals to various providers and community services, reconcile medications during a transition of care, engage patients in their care and provide a dynamic coordinate care plan are essential to building and succeeding along the path to accountability among various providers and with patients. In order to oversee the implementation of those collaboration tools and provide accountability, you need Medicaid Health Home technology that connects your care team quickly and dynamically to act on patient events, care processes and new information.
Payment
One of the most important and pressing questions Medicaid Health Homes raise is how best to handle payment under this new care model. Currently, many ACOs and Medicaid Health Homes are trying to retrofit old payment models to the new paradigm or manage the old and new paradigms simultaneously. This approach isn’t working because, given the diversity of providers (medical, behavioral, social), it is dramatically less efficient and effective to bill incrementally and too complex to manage multiple payment models.
Instead, these organizations need to start viewing their billing coordination efforts along a continuum and from a more whole person care perspective. In the future, payers will have to figure out a new approach to allocation and distribution between different organizations. In order for this new model to be successful, ACOs and Health Homes need the health IT tools and platforms capable of unifying their reporting, allocating payments and providing administrative tracking capabilities.
As new Medicaid Health Home payment models evolve, Medicaid Health Home technology needs to create the sorts of integrated financial tools that allow a diverse group of providers and payers to create a truly cohesive care experience for every patient.
So what does all this mean for ACOs and other networks or organizations currently weighing the benefits of establishing a Medicaid Health Home? While there are plenty of important questions to be asked on a case-by-case basis, one answer is clear: In order to deliver the increased quality of care and potential cost-saving benefits, it pays to invest in the kind of Medicaid Health Home technology that takes the key criteria above into account.
GSI Health recently authored a free downloadable whitepaper for healthcare organizations considering forming a Medicaid Health Home titled, How To Turn The Promise Of Medicaid Health Homes Into Reality. To download it and learn more about GSI Health’s momentum with Medicaid Health Homes, visit medicaidhealthhomes.gsihealth.com
Ms. Lori Evans Bernstein is the President of GSI Health, a health IT provider. Ms. Evans Bernstein has over two decades of experience in healthcare, including: executive roles within health care and health IT corporations; senior federal and state governmental appointments; health care delivery system operations; and health services and policy research. She writes and speaks regularly on health IT across the country and participates in numerous industry and federal and state policy initiatives as a national expert. Follow GSI Health and Ms. Evans Bernstein on Facebook, Twitter and Google+.
http://www.hospitalemrandehr.com/2013/06/06/the-promise-of-medicaid-health-home-technology/?utm_source=Hospital+EMR+and+EHR&utm_medium=email&utm_campaign=bc8b73c855-RSS_EMAIL_CAMPAIGN&utm_content=Yahoo%21+Mail&utm_term=0_179ad21ba4-bc8b73c855-60795937
Related posts:
1. Health IT Stands Out In Health Technology Hazards List
2. AZ hospitals get Medicaid Meaningful Use payments
3. Ross Koppel Poses Questions About Safety and Usability of Health Information Technology
4. Group Develops EMR-Less HIE Technology
5. Are Certifications For “Home-Grown” EMRs Better?
What If EMR Interoperability Was Mandatory?
Jun 05, 2013 09:09 am | By: Anne Zieger
For decades, industries have haggled and coded and bargained their way into shared data standards. Each agreement has made great technical advances possible and grown markets into forms which could hardly have been imagined before.
Traditionally, the idea has been agreeing on interoperable standards is a form of enlightened self-interest. The equasion “interoperability=larger markets=more pie for everyone” has nearly always managed to take root even in industries as brutally competitive as networking. Consider where we’d be without 802.11 for WiFi, for example. If WiFi manufacturers had staged a prolonged battle over standards, and the reach of WiFi didn’t blossom everywhere, the Internet as we know it might not exist.
Well, here in EMR vendor land, we’ve somehow passed the exit marked “coopetition” and wandered off into interoperability nowhere land. Sure, tell me about the CommonWell Alliance, which looks, on the surface, something like industry cooperation, and I’ll retort, “too little, too late.” And do I even have to say that the idea that Epic supports everybody is something of a laughing matter?
Maybe, after seeing how miserably the EMR vendor industry has failed to come together to share data, it’s time to force the matter. I read that ONC honcho Farzad Mostashari has occasionally threatened to do just that, but hasn’t followed through with any proposed regs on the subject.
What if the FCC, the FDA and the ONC (which are now taking comments on a regulatory framework for health IT) decide to look at standards, pick a winner and shove it down the ever-living throat of every uncooperative vendor hoping to create dependency on their way of doing things? That would include Epic, of course, which today, hears countless hospital CIOs say they had to buy their product because everybody else did.
Don’t get me wrong, this is a very, very serious matter; any regs that attempted to force interoperability would impose untold billions in costs on vendors, not to mention their customers. But if interoperability is the real prize we’re ultimately hoping to gain — the big EMR enchilada — is it possible that it’s time to take the risk anyway? I don’t know, but I certainly wonder. How about you, readers?
http://www.hospitalemrandehr.com/2013/06/05/what-if-emr-interoperability-was-mandatory/?utm_source=Hospital+EMR+and+EHR&utm_medium=email&utm_campaign=8574635861-RSS_EMAIL_CAMPAIGN&utm_content=Yahoo%21+Mail&utm_term=0_179ad21ba4-8574635861-60795937
Related posts:
1.Epic Not Invited To CommonWell Interoperability Alliance
http://www.hospitalemrandehr.com/2013/03/07/epic-not-invited-to-commonwell-interoperability-alliance/?utm_source=Hospital+EMR+and+EHR&utm_campaign=8574635861-RSS_EMAIL_CAMPAIGN&utm_medium=email&utm_term=0_179ad21ba4-8574635861-60795937
2.Only Incentives Will Make EHR Interoperability Happen
http://www.hospitalemrandehr.com/2013/04/26/only-incentives-will-make-ehr-interoperability-happen/?utm_source=Hospital+EMR+and+EHR&utm_campaign=8574635861-RSS_EMAIL_CAMPAIGN&utm_medium=email&utm_term=0_179ad21ba4-8574635861-60795937
3.Is EMR Interoperability A Pipe Dream?
http://www.hospitalemrandehr.com/2012/01/28/is-emr-interoperability-a-pipe-dream/?utm_source=Hospital+EMR+and+EHR&utm_campaign=8574635861-RSS_EMAIL_CAMPAIGN&utm_medium=email&utm_term=0_179ad21ba4-8574635861-60795937
Good morning LeftC, BSB & MMRF Boardee's.
I do not understand the FB post either. However when BL called me last Tuesday & we were talking... he said he wished he could inform me of several things but was unable to mention it to me at the time. I took that as he was referring to insider trading laws. None the less I am looking for some good news.
As Telly Savalas said in the movie "Kelly"s Heroes"
Stay safe... You Knuckle Heads!
From MMRGlobal's FaceBook Page
MMRGlobal
Dateline: Los Angeles at 8:30 PM PDT, Stay tuned!
A message from MMRGlobal Investor Relations.
http://phx.corporate-ir.net/phoenix.zhtml?c=178404&p=irol-irhome
In response to questions from stockholders about MMR’s Facebook post of May 30th, the Company still plans on making the announcement regarding “Peace Talks” in Syria, Russia, Colombia, China, Israel, India, Pakistan and the U.S. by the end of the day tomorrow, June 6th. Therefore, if you’re visiting the Kremlin in Russia, walking the Great Wall in China, floating in the Dead Sea in Israel, scoping out Saladin’s Castle in Syria, cruising through the Amazon Rainforest in Colombia, taking pictures at the Taj Mahal in India, or climbing K2, the world’s second highest mountain, in Pakistan, you still have 12 to 15 hours to read it right here. If you happen to be in the U.S., you have 25 to 28 hours more, depending on your distance from Los Angeles.
The fact is that your management team and all the Company’s lawyers are working tirelessly around the world with overtime in Australia, Singapore, Canada and Japan. So please remember progress is always worth waiting for.
MMRGlobal, Inc.,: Investor Relations - Invest in the Future of Healthcare
phx.corporate-ir.net
MMRGlobal.
Beware: The top 4 hurdles to a successful EHR implementation
'These aren't out of the box solutions...providers should plan for them at the beginning.'
May 31, 2013
If you were a healthcare provider and all you did was read press releases, you'd be tempted to think that transitioning to a new EHR involved little more than opening the package and plugging in the contents.
Naturally, things are a little more complicated than that, but many providers aren't aware of just how much more complicated the truth really is.
As Michael Gleeson, senior vice president of product strategy for Arcadia Solutions, a Boston-based health IT consulting company, put it recently, "We've found that using technology is really new for a lot of practices."
Given that naiveté, Gleeson said, many practices struggle with performance issues related to their workflows, largely because their care delivery structures aren't always suited to taking advantage of EHRs and they're not clear on the proper steps toward greater efficiency.
As Gleeson sees it, there are four generally unanticipated issues that providers encounter when they transition from paper records to EHRs.
1. Network issues. "This," said Gleeson, "is one of the most difficult areas." He went on to explain that if a practice uses a hosted EHR, accessing it through the Internet, it could cause delays as the information gets loaded slowly. That, naturally, leads to provider frustration.
2. Untested upgrades. Upgrades make things better, right? Maybe. The problem, according to Gleeson, is that "the upgrade might come from the vendor, but the customer has customized the original system and the upgrade hasn't been tested within their own (now customized) ecosystem."
3. Ineffective template design. Templates are a love 'em or hate 'em proposition. On the one hand they allow for data input uniformity, while on the other they often restrict the capacity of providers to make comprehensive notes. On an operational level, Gleeson pointed out, templates are often just plain inefficient, and they offer too many distracting alerts. Providers new to EHRs may not understand how to solve either of those problems.
4. Genuine application performance issues. Many problems, Gleeson said, stem from how the EHR has been deployed. Again, these aren't plug-and-play systems, a fact which too many providers don't realize until they're knee deep in impediments to productivity. The good news, however, is that systems can be analyzed, with an eye toward determining what modules need to be tweaked or moved to different parts of the system.
While there are few problems that can't be solved post-implementation, Gleeson pointed out that often providers don't realize they have problems to correct until their systems have been in place for some time. In large part, that's because even less than optimally installed EHRs can help with upcoding right away. Consequently, providers who may now be able to bill for services that once fell by the wayside may not realize until later that, in reality, their overall productivity has decreased.
The truth, Gleeson said, is that the problems listed above can lead to up to a 30 percent decrease in productivity.
http://www.healthcareitnews.com/news/beware-top-4-hurdles-successful-ehr-implementation
Study: Few docs have EHRs that meet MU measures
Fewer than 10% of primary care and specialty physicians had EHR systems that satisfy the meaningful use criteria set by the federal government, according to a study in the Annals of Internal Medicine. Only 43.5% of respondents said they had a basic EHR. The study was conducted from late 2011 to early 2012 and involved 1,820 primary care doctors and specialists. Bloomberg Businessweek (6/4), Medscape (free registration) (6/3)
Read the Full Story:
http://www.businessweek.com/news/2013-06-03/most-doctors-don-t-meet-u-dot-s-dot-standards-for-electronic-records#_=1370382855515&id=twitter-widget-0&lang=en&screen_name=BW&show_count=false&show_screen_name=true&size=m
More patients accepting treatment from nonphysicians
By Andis Robeznieks
Posted: June 4, 2013 - 1:15 pm ET
As predictions of a looming doctor shortage become more severe, two recent surveys find that more family physicians are working with nurse practitioners, physician assistants and certified nurse midwives. They also found that patients increasingly are accepting treatment by nonphysicians—particularly when the alternative is to wait a day or longer to see a doctor.
According to a policy brief published in the Journal of the American Board of Family Medicine, nearly two-thirds (59.8%) of the 5,818 family physicians surveyed said they routinely worked with an NP, PA or CNW. The brief, written by physicians affiliated with the Robert Graham Center for Policy Studies in Family Medicine and Primary Care, cited previous studies that physicians working with these mid-level professionals grew from 25% in 1999 to nearly 50% in 2009. The online survey was conducted between September and October of 2011.
“This survey shows that family physicians are embracing collaborations with nurse practitioners, physician assistants and other health professions colleagues,” co-author Dr. Andrew Bazemore, director of the Graham Center, said in a news release.
Another survey, published in Health Affairs, found that people still prefer to see a doctor, but are OK seeing a nonphysician provider if that means getting treated more quickly. Even then, there was not an overwhelming preference for doctors. The survey asked respondents if a practice had physicians, physician assistants or nurse practitioners, who would they prefer to see? Just over half (50.4%) said they would prefer to see the physician, while 25.9% said they had no preference, and 22.8% preferred an NP or PA.
The survey then provided two scenarios: Would you rather see an NP or PA today for a worsening cough, or wait to see a physician tomorrow? And would you prefer to see an NP or PA in one day, or a physician in three days for frequent headaches? In the first scenario, 59.6% preferred to be treated that day by a nonphysician (15.1% had no preference or were unsure). In the second, 66.6% said they would rather see an NP or PA the next day (11.3% had no preference or were unsure).
“State regulations limiting scope of practice for physician assistants and nurse practitioners present a major practical barrier to these clinicians' expanded role in care,” the report concluded. “Efforts to standardize scope of practice for physician assistants and nurse practitioners at a level that enables them to take full advantage of their training and skills have the potential to improve access, especially for underserved populations.”
The report, written by researchers with the Association of American of Medical Colleges, was based on a survey of 2,053 adults who indicated that they or a physician believed that they needed medical care at least once in the past 12 months.
http://www.modernphysician.com/article/20130604/MODERNPHYSICIAN/306049973?AllowView=VW8xUmo5Q21TcWJOb1gzb0tNN3RLZ0h0MWg5SVgra3NZRzROR3l0WWRMWGJVdjBGRWxYek9UYktwUGZUamg5b1g4WFFERmhzbHhWSnRqYk9XNkU9&utm_source=link-20130604-MODERNPHYSICIAN-306049973&utm_medium=email&utm_campaign=mpdaily
Good morning SS, well damn, ain't I the dummy/dumb 1. Notice I put a period @ the end of that statement & not a ? mark. No answer needed. lol...
Stay safe & thanks for the schooling!
Tulz, good read, thank you! I enjoy reading these articles. Though the publisher of the article had several misspells.
“When the company was founded in 2005, I coming from a telecommunications background firmly believed in standardisation, began to look at the industry and despite the talk about standardisation, I didn't believe it,” he said.
IVB & Lickety, it was also announced that MMRF was preparing meetings with the Australian government in June. That is correct isn't it? If so does anyone know when that is to take place?
Good Morning Dshade, and what is that telling you? Please expand I am interested in your opinion? Thanks!
Damn Pilot, did you borrow FJ74 escavator? I appreciate all the good read this morning on the Bio side & Dr. Royston.
Rand: DoD must consider privacy, consent in VLER, HIE
May 29, 2013 | Anthony Brino, Associate Editor
As the U.S. Department of Defense looks for a new EHR system and aims to improve information sharing for veterans with lifetime digital health records, there are also several key patient privacy questions to consider.
According to a recent Rand Corporation report, the Pentagon will have to work through a number of patient privacy issues in the coming years — just as it looks to HIE and the virtual lifetime electronic health record (VLER) to help control costs, with the TRICARE health plan accounting for about 7 percent of the DoD’s annual budget, at $54 billion.
Among the healthcare industry, largely under HIPAA’s direction, there’s a general consensus about the principles that should guide HIE — patient consent, provider disclosure and information accuracy. “However, there is less consensus about the specific approaches used to implement these principles,” wrote Rand researchers Susan Hosek and Susan Straus.
The central issue of privacy — patient consent and authorization for HIE — often comes with ambiguity and some controversy or even contradiction in patient sentiment. Public comments on HIPAA rules throughout the years, Hosek and Straus noted, show quite a few individuals saying they “own” their health records and that they should be asked for permission to release their data at every provider request. At the same time, surveys Hosek and Straus cited have found broad support for information exchange to improve medical care transitions and coordination.
Among the changes DoD will need to consider, Hosek and Straus suggested, are the ability to record and implement patient restrictions on protected health information and more granular methods for consent on PHI for non-DoD providers. They also suggest the DoD consider the potential designs and usability of automated text processing to redact restricted PHI, particularly in unstructured data forms, like clinical notes.
The VLER will also need a well-defined consent framework, they argued. “We expect that it may be difficult to proceed with VLER without a meaningful consent procedure that reflects the principles proposed by the Office of the National Coordinator for Health Information Technology’s HIT Policy Committee ‘Tiger Team.’”
The Tiger Team’s proposal calls for “meaningful, revocable” consent for HIE, except for direct provider-to-provider exchange. Although HIPAA does allow providers to exchange patient data for treatment, payment and operations without patient authorization, Hosek and Straus said few civilian providers participating in TRICARE would be able or willing to do that, so the DoD may end up following the VA with a patient consent management system.
[See also: VA expanding new strategy for claims backlog.]
Two other related issues the DoD will have to consider are patient identifiers and patient-matching systems.
“Without a national system of unique patient identifiers, patient identity matching for HIE poses difficult challenges,” Hosek and Straus wrote. “Even if a unique patient identifier were established, the potential for errors in recording it would require additional matching on other patient identifiers to ensure that the right patient’s information is being exchanged.”
And in choosing between identifiers or matching algorithms, the DoD would not have much evidence to consider, they noted. Of the studies that have evaluated the relative merits and drawbacks of the two approaches, researchers used either simulations or proxy patient indexes. So there’s “very limited real world information on which to base a choice of patient identifiers, matching algorithm, match criteria, and manual review of the results of automated matching.”
Looking at the long-term needs for a VLER, Hosek and Straus suggested that the DoD evaluate several approaches to matching at a large scale, which is likely to be necessary as more civilian providers participate in the military health system and TRICARE, which currently covers health benefits for almost 10 million active and retired Pentagon employees.
Those evaluations, they wrote, should use “actual identifying data” from the DoD’s person data repository to test performance at scale and then to pilot approaches that show promise. The DoD should also measure the trade-offs in various approaches, they suggest, considering time needed to complete patient information requests and false negative and positive rates in patient matching.
See also:
Slideshow: Apps to aid vets
Patient ID proofing for EHR access must be easy, says ONC policy committee.
http://www.govhealthit.com/news/rand-dod-must-consider-privacy-consent-vler-hie
Survey: Meaningful Use Incentives Fuels EHR Adoption to All-Time High
Meaningful Use incentives fuels EHR adoption to all-time high according to recent 2013 Physician Practice Technology Survey.
U.S. adoption of electronic health records (EHR) systems among medical practices has reached an all-time high with more than three in four physicians utilizing EHRs. 62 percent of EHR adopters say they have already successfully attested for meaningful use stage 1, according to the 2013 Physicians Practice Technology Survey, sponsored by ZirMed.
24 percent of the 1,291 physicians surveyed from November 2012 to March 2013 said they still had no EHR access, and about 30 of this group expect to adopt one soon. EHR adoption is a critical step in the transformation of the U.S. health care system that focuses on outcomes rather than services. In order to demonstrate quality, providers need access to the data that EHR systems collect.
Growing “EHR Backlash”
The survey results also provides concrete support for the growing trend of “EHRbacklash” in recent months from several industry leaders and organizations. The survey reported only 54 percent of physicians saying they are “satisfied” or “very satisfied” with the performance of their EHR vendor, down from 63 percent just two years ago. Only 43 percent of physician surveys feel they have achieved a return on investment (ROI) concluding that the verdict is still out on the ROI of EHR adoption.
Other survey key findings include:
57 percent have started preparing for Meaningful Use Stage 2
63 percent of surveyed physician practices is part of a health information exchange
EHR adoption and implementation represents the most pressing inforamtion technology problem
50 percent can access their EHR via tablet or smartphone
Only 57 percent of EHR adopters report that their systems have made their practices more efficient
Primary reason some physician practices have not purchased an EHR is they’re too expensive (37 percent)
The full survey finding can be found here
http://www.hitconsultant.net/2013/05/31/survey-meaningful-use-incentives-fuels-ehr-adoption-to-all-time-high/
Hello Bsb, how do you relate a Walgreen settlement to the FB announcement? Thanks!
From MMRGlobal FB Page
MMRGlobal shared a link.
about an hour ago.
Peace Talks
Syria, Russia, Colombia, China, Israel, India, Pakistan and the US, and many others including the IRS, Fox News, Howard Stern and Katie Couric are all in “Peace Talks.” And so is MMRGlobal.
Expect an announcement by June 6th at https://www.mmrglobal.com , https://www.facebook.com/MMRGlobal?ref=hl and https://twitter.com/mmrglobal
WEBINAR: Moving to Stage 2 of Meaningful Use
On Tuesday, June 4 at 12 p.m. EST, Robert Anthony, a health specialist in the CMS Office of E-Health Standards and Services, will share specific meaningful use measures and identify what changes need to be made by your medical practice to continue receiving EHR Incentive payments in 2013 and beyond. Anthony will also take your meaningful use questions live. Space for this free event is limited and registration is required. To register, click here. http://www.physicianspractice.com/meaningful-use/moving-stage-2-meaningful-use?GUID=F8F0782F-425F-40DE-9B50-632EB9F800B6&rememberme=1&ts=30052013
For more information, be sure to visit our meaningful use topic resource center. http://www.physicianspractice.com/meaningful-use
Epic leads in ambulatory-care EHR incentive payments
By Joseph Conn
Posted: May 29, 2013 - 2:30 pm ET
Epic Systems Corp. sits atop a heap of more than 400 developers of complete electronic health-record systems for ambulatory-care physicians and other eligible professionals who have received federal EHR incentive payments, federal data shows.
The privately held company, based in Verona, Wis., claims 54,481 eligible professionals (EPs), for a 22.1% market share in this key EHR niche. This covers providers that either have met meaningful-use goals under the Medicare version of the program or “adopted, implemented or upgraded” to a certified system under the Medicaid version.
Running second in the EP ambulatory-complete EHR category is Allscripts Healthcare Solutions, with 27,261 customers receiving federal incentive payments, for an 11.1% share. Others in the top five are eClinicalWorks with 18,375 customers (7.5%); NexGen HealthCare, with 16,838 (6.8%); and GE Healthcare, with 14,148 (5.7%). The top five developers combined account for 53.2% of the 246,534 providers in this segment. The top 10 vendors claim (66.1% of customers paid in the EP ambulatory-complete EHR market). A whopping 449 developers have at least one user of their EHRs receive federal payments under this segment of the program.
More than half ($14.6 billion) of the estimated $22.5 billion available for federal EHR incentive payments has been spent, according to the latest figures through April from the CMS. Interoperability between the myriad available EHR systems remains a work in progress, however, and the subject of recent criticism of the federal IT program from several Republican members of Congress.
The EHR market data comes from a mashup of two federal databases kept by the CMS and HHS' Office of the National Coordinator for Health Information Technology that pairs paid providers to the systems they used to qualify for EHR incentive payments under the American Recovery and Reinvestment Act of 2009. The database has records of 297,752 payments made since January 2011 through February this year, including 291,079 to EPs and 6,673 to hospitals.
Epic also leads with the most customers using hospital-complete EHRs in inpatient care, federal records show; Meditech leads for hospitals using modular EHRs for inpatients.
The category of Medicare and Medicare Advantage EPs includes physicians, optometrists, podiatrists, chiropractors and dentists. Medicaid EPs are physicians, dentists, physician assistants, nurse practitioners and certified nurse-midwifes. EPs can qualify for payments under either one of the programs, but not both.
Cerner Corp., based in Kansas City, Mo., is the runaway leader in the smaller category of EPs in ambulatory care that are using modular EHR systems. There are 11,679 Cerner customers, or 31.1%, of a total of 37,573 EPs in ambulatory care who use modular EHRs to receive federal incentive payments. Second in the category is Intermountain Healthcare, with 6,083 providers, or 16.2% market share, followed by Allscripts, with 5,057 (13.5%); Jardogs, acquired by Allscripts in March, with 2,686 (7.1%); and GE Healthcare, with 1,451 (3.9%). The top five developers account for 71.7% of the paid EPs in this category, but 91 developers have at least one provider receiving federal payments in this market niche.
For EPs in the inpatient environment using complete EHRs, Epic Systems grabs the lion's share with 2,062 paid users, or 45.3% of this niche of 4,550 paid providers. GE Healthcare follows with 1,053 EPs, or 23.1%, and Cerner, with 933, o r20.5%, with the top three developers claiming 89% of this market segment. A total of 24 developers have at least one EP using their system and receive payment.
Among EPs in inpatient care using modular EHRs, Cerner is far and away the leader with 1,664 providers receiving payment, or 71.4% of 2,332 providers in total. Allscripts is a distant second at 345 paid providers, or 14.8%, and Meditech third, with 168 providers and 7.2%. And while the top three developers have 93.4% of this segment, 17 developers in this niche had at least one paid customer.
http://www.modernhealthcare.com/article/20130529/NEWS/305299954?AllowView=VW8xUmo5Q21TcWJOb1gzb0tNN3RLZ0h0MWg5SVgra3NZRzROR3l0WWRMWGJVZjhJRWxiNUtpQzMyWmV1NVhVWUpibWw=&utm_source=link-20130529-NEWS-305299954&utm_medium=email&utm_campaign=hits
Defense Dept. weighs commercial vs. open-source EHR
By Joseph Conn
Posted: May 29, 2013 - 4:00 pm ET
Tags: Electronic Health Records (EHR), Hospitals, Information Technology, Military Health, U.S. Department of Veterans Affairs
Will the Defense Department buy a commercial electronic health-record system and consummate one of the largest healthcare information technology deals in U.S. history?
Or will the sprawling, 56-hospital, 361-clinic Military Health System line up with the Veterans Affairs Department and use a modified version of the VA's venerable VistA EHR, an open-source system that has a strong track record in VA facilities?
The answer is that no one, not even Defense Secretary Chuck Hagel, can say for sure which way Defense will go. EHR vendors, meanwhile, are salivating over the prospect of selling a new EHR system to the Defense Department, which could cost an estimated $6 billion or more.
Hagel and the Defense Department are likely under intense lobbying pressure to buy a commercial system, according to sources contacted for this story, even though the VA adopted plans to improve VistA using an open-source system development model, which VA officials deem to be a cheaper, faster way to improve their health IT system.
The lobbying is likely coming from developers, consultants, systems integrators and implementers, members of Congress and members of the military who are looking to leverage the contract for employment opportunities both during their military service and afterwards.
In February, the Defense and VA cabinet secretaries and the VA scrapped as too expensive a 5-year-old effort to develop a new, single, joint EHR for the two health services.
Last week, Hagel issued a memorandum, and one of his undersecretaries, Frank Kendall held a news conference on Defense's proposed new path.
Hagel said he was convinced that “a competitive process is the optimal way to ensure we select the best value solutions for DoD.” But Hagel also said that “a VistA-based solution will likely be part of one or more competitive offerings that DoD receives.”
Kendall, at his news conference May 22, said after doing market research, “we had about 20 responses from industry” by firms interested in bidding on the system. Three proposals were VistA-based approaches.
Kendall did not put his recommendation to Hagel in writing and declined to be interviewed for this story. That leaves pretty much a blank slate on which an EHR developer—proprietary or open source—can project their hopes and dreams.
“My read is that DoD has established a level playing field for a VistA-based open-source approach, other open-source approaches and nonopen-source approaches,” said Seong Mun, president of the Open Source Electronic Health Record Agent, a not-for-profit corporation created by the VA in 2011 to oversee its open-source project to upgrade VistA.
Although OSEHRA itself won't bid on an implementation of its open-source version of the VistA software, Mun said, some of its member companies could. He added that OSEHRA members put together a very credible assessment for Defense in response to its request for information.
Mun said he was “not disappointed” that Defense did not accept the VistA overture outright. “Even if one prefers one thing over the other, it still has to go through open bidding,” he said.
Tom Munnecke, a pioneering health IT programmer at the VA who helped develop both the VA and Defense EHR systems and currently works as a consultant, said the newly announced Defense approach using competitive bidding sounds “almost identical” to what it used back in the 1980s. One tell whether the new procurement program will go down the same path as the old one will come when the bid specifications for the new military EHR are written.
Former VA programmer Rick Marshall, executive director of the VistA Expertise Network, a not-for-profit collaborative of IT consultants and programmers, said Hagel is probably under tremendous pressure to open the process to competitive bidding. But whether VistA will be part of that mix remains to be seen.
“Even if I intended to go with VistA, I'd probably do what he is doing,” Marshall said. And yet, based on the memo, Hagel may have no intention of choosing anything other than an off-the-shelf, commercial EHR, according to Marshall. “It is the perfect Washington, D.C., maneuver, saying whatever people want to hear.”
Marshall said the best possible approach is to begin with that portion of VA-cloned software code that the Military Health System still uses to develop a new system. The VA, Defense and the Indian Health Service, which also uses a VistA-derived EHR in its healthcare network, would install those packages to unify their three systems.
“I think the DoD would go for it,” Marshall said. “They would have all their data and they would be getting decades of progress (from the VistA code that's more advanced), and even the VA would be getting some progress. And, because they're on the same code base, then they can decide what they want to spend on upgrades.”
Dr. Nancy Anthracite is president and chief medical officer of WorldVistA, a not-for-profit organization created in 2002 to promote the use of VistA outside the VA. She attributes much of the Defense Department's recent attention to VistA to comedian Jon Stewart, who broadcast a scathing critique of the inability of the two cabinet departments to work together on a common EHR.
“It made Congress sit up and pay attention,” she said. “There is no doubt in my mind that DoD should be using VistA.”
During his news conference, Kendall hedged when asked how much a new military EHR might cost. “We're going to have to assess that, OK?”
The VA's healthcare division, the Veterans Health Administration, is more than twice the size of the Military Health System. According to the VHA, it operates 151 hospitals and 827 clinics. Its former CIO, Roger Baker, said $16 billion was a reasonable estimate of the cost to replace VistA with a commercial off-the-shelf system at the VA alone. By that gauge, a commercial system for the Military Health System would cost more than $6 billion.
Another major consideration for the Defense Department and Kendall, who will retain a leadership role in the military's EHR procurement process, is the Obama administration's stated preference for open standards and open-source software.
Asked whether going with a proprietary EHR system might impede the president's push for open standards, Kendall said that is a concern. “One of the other things we have to consider is the degree to which we're locked into a specific vendor because of proprietary content and his products,” Kendall said. “As we go out and we ask people to bid to us, that's one of the things we're going to assess. We do not want to be locked into a specific vendor for the long-distance future.”
http://www.modernhealthcare.com/article/20130529/NEWS/305299953?AllowView=VW8xUmo5Q21TcWJOb1gzb0tNN3RLZ0h0MWg5SVgra3NZRzROR3l0WWRMWGJVZjhJRWxiNUtpQzMyWmV1NVhVWUpibWk=&utm_source=link-20130529-NEWS-305299953&utm_medium=email&utm_campaign=hits
BL/Lawyers may want to look into this.
Mayo Clinic Health System introduces online portal for patients
A Web-based portal was unveiled by the Mayo Clinic Health System to allow patients in Wisconsin, Iowa and Minnesota to easily access their health data, including laboratory results and prescription histories. The portal can also be used by patients to send secure messages to providers and ask for prescription renewals. KIMT-TV (Iowa)
Online Access for Mayo Clinic Health System Patients
By Raquel Hellman Published: Tuesday, May 28, 2013, 4:54 pm
For Mayo Clinic Health System patients, access to personal medical information is now at your fingertips.
Mayo Clinic Health System has launched an online portal for patients in Minnesota, Iowa and Wisconsin.
You’re be able to get lab results, review your history of prescriptions or check on your next office visit. Patients can also exchange secure messages with their healthcare provider and request appointments or prescription renewals.
To create an account, visit http://mayoclinichealthsystem.org/ or you can download the Mayo Clinic patient app on your iOS or Android device.
http://www.kimt.com/2013/05/28/online-access-for-mayo-clinic-health-system-patients/
Storm tests EHR, Medical records kept safe despite devastation
By Joseph Conn
Posted: May 25, 2013 - 12:01 am ET
When thousands of Gulf Coast residents fled Hurricane Katrina, many of their paper-based medical records were soaked or blown to the winds. Ever since, proponents of electronic health-record systems and health information exchanges have promoted those technologies to keep health information secure and accessible when disasters strike.
In and around Oklahoma City last week, that promise was largely fulfilled.
The tornado that struck Moore, Okla., on May 20 knocked out Internet communications to Moore Medical Center, the city's lone hospital, a satellite of Norman (Okla.) Regional Health System.
About 30 patients were evacuated from Moore Medical in the south suburb of Oklahoma City to the system's unscathed flagship, Norman Regional Hospital, and its HealthPlex surgical hospital, also in Norman, both less than 10 miles farther south.
Since the main campus hosts the Meditech EHR systems for all three hospitals, even with Internet connectivity knocked out, Norman “didn't skip a beat,” said Dr. Brian Yeaman, a family physician and practicing hospitalist and the system's chief medical informatics officer. “And we didn't have the risk of those paper records flying for miles.”
Yeaman also is the medical director for the Greater Oklahoma City Hospital Council and coordinator of its health information collaborative, a subset of Oklahoma's broader Secure Medical Records Transfer Network, or SMRTnet, a 7-year-old regional health information exchange organization that also was tested by the storm.
Copies of patient records for more than 2 million people are stored by SMRTnet at a Cerner Corp. data warehouse “buried in the side of a large, manufactured hill in Kansas City,” said Joanna Walkingstick, director of member services at SMRTnet. Those records include patient demographics, visits, procedures, lab results, vital signs, histories and physicals, discharge summaries, discharge medications and radiology reports.
“This is the first time we've been tested like this,” Walkingstick said. Network traffic spiked after the tornado hit, and the system “scaled” and “handled the traffic load, very, very well,” she said.
There was a weak link: The lines of the fiber optic cable provider used by Norman Regional Health to connect to SMRTnet were cut just after 3 p.m., when the tornado moved eastward across Interstate 35, the main traffic artery between Oklahoma City and Norman.
The ensuing destruction disconnected Norman from the RHIO until about 10 p.m., when service was restored.
Links between SMRTnet and other network member hospitals stayed open, however, Yeaman said, including to the Integris Southwest Medical Center, 10 miles north of the now-iconic Plaza Towers Elementary School destroyed by the tornado.
“Everybody had access to the data they needed,” said John Delano, vice president and chief information officer of Integris Health, which has five hospitals in the Oklahoma City area.
“We did not lose connectivity,” Delano said. “Our (Cerner) electronic medical record is remote hosted in Kansas City. We've got two ways to get to that: We've got a private connection and we have the ability to access them via the Internet should we lose that. And, we keep a local copy of the data. And we're connected to SMRTnet. We also use Allscripts in our ambulatory environment, and we're in the process of dumping that ambulatory data into that HIE as well.”
Integris providers treated 92 tornado victims, 20 of whom were admitted, 10 in critical condition, and one of whom died, said Brooke Cayot, media liaison for the system.
Yeaman said SMRTnet connects 90% of the hospital beds in the greater Oklahoma City area. Research by the local hospital council, he said, indicates that 68% of the area's patients “touch more than one health system and 25% see three or more.” That diffusion of patients was most certainly the case after the storm.
Injured Moore residents, who ordinarily would have sought treatment in their city's hospital, did so across the metro area.
“We were able to put that information in those providers' hands (Monday night) to make very difficult decisions on some very sick patients and drive care,” Yeaman said. “It's absolutely mind-boggling to think about the corner we've turned.”
http://www.modernhealthcare.com/article/20130525/MAGAZINE/305259978/1139?AllowView=VW8xUmo5Q21TcWJOb1gzb0tNN3RLZ0h0MWg5SVgra3NZRzROR3l0WWRMWGJVZjhFRWxYOU9qTENvK25lK0g4UktiNmtlMDVvbnd4SXN6ek8=
You all are smart than I so you all correct me where I'm wrong. But in respense to BL shareholder memo I would say he wants the extra stocks for incentive purposes for people like Dr. Ivor Royston, etc...
Hello IVB, I like how you deliver a meesage. Happy Memorial Day weekend to you & all of the MMRF boardies.
WEBINAR: Moving to Stage 2 of Meaningful Use
On Tuesday, June 4 at 12 p.m. EST, Robert Anthony, a health specialist in the CMS Office of E-Health Standards and Services, will share specific meaningful use measures and identify what changes need to be made by your medical practice to continue receiving EHR Incentive payments in 2013 and beyond. Anthony will also take your meaningful use questions live. Space for this free event is limited and registration is required. To register, click here. http://www.physicianspractice.com/meaningful-use/moving-stage-2-meaningful-use
Calif. tool helps make record-sharing decisions
California health officials have developed a tool to help providers decide when they need patient authorization to share treatment records as California builds an electronic highway for medical information. FULL STORY » http://www.bizjournals.com/sacramento/news/2013/05/21/provider-tool-patient-record-sharing-hea.html
Hagel considers commercial EHR system
By Joseph Conn Posted: May 23, 2013 - 4:00 pm ET
The Defense Department is back in the market for an electronic health-record system for its sprawling healthcare empire, according to a memorandum from Defense Secretary Chuck Hagel. FULL STORY » http://www.modernhealthcare.com/article/20130523/NEWS/305239954?AllowView=VW8xUmo5Q21TcWJOb1gzb0tNN3RLZ0h0MWg5SVgra3NZRzROR3l0WWRMWGJVZjhDRWxiNUtpQzMyWmV1NVg4WUpibWw=&utm_source=link-20130523-NEWS-305239954&utm_medium=email&utm_campaign=hits
Hello Mick, do you have a link to view this. I have been searching but can not find it. Thanks!
At the doctors office today I was reading my latest issue of Fortune magazine & read this article. Thought some of you might find it interesting. PatientsLikeMe might be a good lead/partner for MMRF.
Social media comes to health care
http://money.cnn.com/2013/04/11/technology/social-media-health-care.pr.fortune/index.html
PatientsLikeMe
http://www.patientslikeme.com/
daveyo, I appreciate you posting the information, but I would appreciate more if you would post the hyperlink to where you received the information from. Thanks!
EHRs and MU
Most CIOs back proposed one-year extension of stage 2 MU
A recent healthsystemCIO.com survey reveals that 76.3% of CIO respondents support the proposed one-year delay of the stage 2 meaningful use rule deadlines. The survey also notes that while barriers such as tight deadlines and interoperability issues remain, most CIOs say the MU effort has moved the industry in a positive direction and it's important to push ahead with it. Read more... http://healthsystemcio.com/2013/05/22/survey-says-cios-support-mu-delay-but-still-cite-flaws/
DOD seeks commercial systems to replace its EHR platform
Frank Kendall, the Defense Department's undersecretary for acquisition, technology and logistics, announced the agency has identified 20 commercial EHR vendors that could develop modernized systems to replace its Armed Forces Health Longitudinal Technology Application. While stressing that DOD is seeking a modern, advanced commercial system that will satisfy its EHR needs, Kendall also said the Veterans Health Information Systems and Technology Architecture, or VistA, could also be a potential replacement for the DOD EHR. Read more... http://www.nextgov.com/health/2013/05/pentagon-says-20-vendors-can-meet-its-electronic-health-record-needs/63524/
EHNAC certifies 4 vendors for secure messaging services
The Electronic Healthcare Network Accreditation Commission, a standards development organization that launched the Direct Trusted Agent Accreditation Program, has certified Cerner, Informatics Corporation of America, Max.MD and Surescripts for Registration Authority, Certificate Authority and Health Information Service Provider functions. EHNAC's accreditation shows vendors were able to meet the standards for offering secure Direct messaging services. Read more... http://www.healthdatamanagement.com/news/health-information-exchange-secure-messaging-direct-project-46175-1.html