Tag Archives: EHR

Optometry Software for Mac OS X

Posted on 01. Mar, 2010 by Brad Rourke.

More optometrists and retail optical stores are switching to Practice Director because Practice Director is fully Mac compatible. Mac compatibility isn’t the only reason they are switching to Practice Director, but it is one of many.

We recently deployed Practice Director on another all Mac multi-location optometry office. The server-side software of Practice Director was installed on a Mac Pro with 16GB RAM that supports connections from offices with approximately 10 users at each location. Users at each location are using a combination of MacBooks, iMac’s and MacBook Pro’s for their work stations. This professional office chose Practice Director because of its simple to use and integrated Electronic Health Record (EHR) and its ability to run in Mac OS X environments.

Another of our customers said the following about their experience with Practice Director migrating from PC/Windows to Mac OS X.

“What is really appealing about Practice Director is that most of us have had experience with a PC crashing and entertain switching to Mac. The main problem with switching is the expense of switching all computers at once. With Practice Director, you can switch one at a time, like we are doing, and the program works with all.” Drs Kevin & Joy Kissel O.D.; kissel@fastem.com

I’d love to hear your comments and if you’ve entertained the idea of switching from PC/Windows to Mac OS X, and why or why not?

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What’s the Probability You Will Receive EHR Stimulus Payments?

Posted on 25. Feb, 2010 by Brad Rourke.

Kathleen Sebelius, Secretary Health and Human Services (HHS), was required to issue initial guidance on ‘Certification’ and ‘Meaningful Use’ of Electronic Health Records (EHRs) by December 31, 2009. This requirement is pursuant to the 787 billion dollar American Recovery and Reinvestment Act (ARRA), also referred to as the stimulus plan.

Per the HHS website, on December 30, 2009, the Office of the National Coordinator for Health Information Technology (ONC) issued an Interim Final Rule (IFR) that specifies the Secretary’s adoption of an initial set of standards, implementation specifications, and certification criteria for health record technology.

In short, although there is still much work to be done in 2010, the HHS stimulus program is on track, and therefore the probability is increasing that EHR technology adoption stimulus funds will be available to you in 2011.

What Stimulus Funds are available for Optometrists?

A component of the February 2009 Stimulus Plan was enacted to improve health of all Americans as well as improve the efficiency of health care delivery. To this end, qualifying providers (e.g. Optometric Doctors), who demonstrate ‘Meaningful Use’ of a ‘Certified EHR’, are eligible under the Medicare program for up to $44,000 in incentive payments. The incentive payments are meant to offset the cost of acquiring, deploying, training and using EHR technology.

Beginning in 2011, incentive payments will be made to Providers through Centers for Medicare and Medicaid Services (CMS) provided adoption and Meaningful Use of Certified EHR technology is demonstrated. The fundamental terms of payment are as follows:

• Up to $18,000, $12,000, $8,000, $4,000, $2,000 for years 1 through 5, respectively, beginning in 2011 paid out via bonus payments of 75% of your Medicare reimbursements.
• Adoption and demonstration of meaningful use of Certified EHR technology is required by 2012 in order to be eligible for the full $44,000 incentive.
• A penalty of 1% per year of your Medicare reimbursements will go into effect if you have not demonstrated meaningful use of Certified EHR technology by 2015; the penalty is restricted to a maximum of 5 years.
• There are no stated restrictions on the use of incentive payments received.

What is Meaningful Use of a Certified EHR Technology?

The Interim Final Rule (IFR) regulation filings of December 30, 2009 bring us much closer to definitively answering this question.

The two IFR regulation documents that were filed with the Office of the Federal Register by HHS are:

1. Medicaid & Medicare Programs; Electronic Health Record Incentive Program; 556 pages in .pdf format.
2. Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology; 136 pages in .pdf format.

They are available at: http://www.federalregister.gov/inspection.aspx#special

Much of the content is based on the work done by the Health Information Technology (HIT) Policy Committee. The HIT Policy Committee was created by Stimulus Plan legislation and is charged with recommending definitions of Certified EHR Technology and Meaningful Use.

The first document sets out what will be required to demonstrate Meaningful Use. HHS has deemed it appropriate to define the requirements for Meaningful Use in three stages:

Stage-1 defines what Meaningful Use of Certified EHR technology is for purposes of 2011, or year 1, incentive payments. There are 25 Stage-1 one criteria for Providers, a reliable summary of the 25 criteria along with measures can be viewed at:

http://www.healthcareitnews.com/news/eligible-provider-Meaningful Use-criteria

Stage-1 Criteria Examples include:

• 80% of orders must be computer physician order entry (CPOE).
• 80% of all patients must have at least one ‘electronic documentation’ of allergy and medication or an indication of ‘none’.
• 75% of prescriptions written must be transmitted electronically.
• 80% of patients who request a copy of their health record electronically must receive it with in 48 hours.

Stages 2 and 3, which are not fully defined, will focus on the exchange of clinical data and decision support tools respectively. Stage-2 definitions are expected by the end of 2011 and Stage-3, by the end of 2013.

Are Certified EHRs available now?

As of January 2010 there are no HHS certified EHRs available for purposes of the stimulus plan incentive payments. It is quite likely there may not be HHS Certified EHRs available until very late in 2010 or perhaps early 2011.

The second document filed with the Federal Registrar, mentioned above, which covers the Interim Final Rule of certification criteria for EHR technology must be finalized before you will see HHS certified EHRs.

The IFR document makes an important distinction of ‘certified EHR technology’ as opposed to ‘certified EHRs’. The distinction is important because providers can use multiple vendors of EHR technology to satisfy the 25 stage-1 criteria rather than adopting one certified EHR that satisfies all 25.

What should ODs be doing?

Before CMS will cut you a check, you’ll need to demonstrate you are using certified EHR technology in a “meaningful way”.

First, I recommend you become familiar with the 25-Stage 1 Meaningful Use criteria. To do this you can read the Health Care IT news above or other similar summary sources. As an alternative, you can work your way through the Interim Final Rule. The latter is a daunting task, but it is certainly more reliable to obtain the information from the original source versus reviewing another’s summary.

Secondly, although there are no HHS certified EHR technologies available now, I still recommend, if you haven’t done so already, that you adopt a Practice Management system with an embedded EHR. The EHR should be from a reputable vendor who is moving toward certification, and it’s critically important that you have an indefinite contractual right to access patient data with the EHR software. The benefits and advantages of using electronic health records over paper records are well documented.

As a final point on this subject, using Certified EHR Technology is not a legislated requirement that requires your compliance. The stimulus plan legislation explicitly sets out that adoption is voluntary (Section 3006, Title VIII), but as mentioned above, providers that do not adopt will be charged a 1% penalty of Medicare reimbursements.

What is the Williams Group / Practice Director doing to help you?

I’d like to assure you we will follow Meaningful Use and Certification developments closely. We will do our best to help our clients and interested parties understand what is involved and what must be done to satisfy EHR certified technology requirements. The integrated EHR that is embedded into Practice Director’s practice management software system is developed to help you with this endeavor.

For more information, contact us.

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EHR & the Stimulus Plan

Posted on 19. Oct, 2009 by Brad Rourke.

Over the next several months through December 31, 2009, the Secretary of Health and Human Services through the Office of the National Coordinator (“ONC”) will be issuing initial guidance on certification and meaningful use of Electronic Health Records (“EHRs”). The Stimulus plan legislation is fast tracking initiatives and incentives for the adoption of EHRs to, among other objectives, reduce health care costs and improve coordination of care. Below is a summary of the primary processes and incentives for EHR adoption along with steps we at Practice Director are undertaking to ensure you are well prepared.

So the meaningful use, 2011 deadline, has our attention in a very, very important way. The second important issue that we have to deal with is certification. We can only compensate providers if they’re using certified records in a meaningful way.” Dr. David Blumenthal, Chair, National Coordinator for Health IT, Policy Committee Transcript, May 11, 2009.

Here’s what Practice Director is Doing:

We are closely monitoring the source of the Electronic Health Record (“EHR”) certification standards, the decisions of the Health IT Policy & Standard Committees.

The Health Information Technology (“HIT”) Standards Committee is charged with making recommendations to the Office of National Coordinator (“ONC”) and Heath and Human Services (“HHS”) Secretary in order to establish EHR standards and certification. The Inaugural Policy & Standards Committee meetings were held May 11, May 15, June 16, and June 23, 2009.

• We have developed and continue to enhance Practice Director’s EHR with open (non proprietary) technologies to ensure flexibility to meet and exceed privacy, security and electronic exchange of health information standards as they are established.
• We are confident Practice Director is already ahead of the curve for certification purposes to help you meet your requirement of ‘meaningful use’ of EHR technology by 2011.

“You know I believe that when we declare the standards, we shouldn’t set the bar so high, that we will leave all of rural America behind and we will leave the small doctor’s office without the ability to reach the bar, but nor should we accept the status quo.” John Halamka – Harvard Medical School – Chief Information Officer, Vice Chair, HIT Standards Committee Transcript, May 15, 2009.

Electronic Health Record Certification & Meaningful Use

• The process for the adoption of Electronic Health Record (EHRs) certification standards and ‘meaningful use’ standards will be accomplished through the recommendation of two ONC committees, the HIT Policy Committee and the HIT Standards Committee
• The HITECH legislation requires that not later than December 31, 2009, the Secretary shall, adopt an initial set of standards, implementation specifications, and certification criteria.

“So under the expedited process, HHS is required to publish an interim final rule with our initial set of standards implementation, specifications and certification criteria by December 31st of this year which if anybody, for folks who are aware of regulatory process, that’s really fast. Fortunately it is an interim final rule” Jodi Daniel – HIT – Director of Policy and Research ONC, May 15, 2009

American Recovery & Reinvestment Act (“ARRA”) Incentives for Meaningful use of Certified EHR’s

• $18,000, $12,000, $8,000, $4,000, $2,000 for years 1 through 5 respectively; if you can not demonstrate ‘meaningful use’ of a ‘certified EMR’ by 2012 you will not be eligible for the entire $44,000 Medicare incentive.
• A reduction of 1% per year of Medicare reimbursements will go into effect if meaningful use is not adopted by 2015, up to a 5% maximum reduction.
• If meaningful use adoption does not occur during or before 2014, no incentive payments will be made.
• The HITECH Act has provided definition guidance pertaining to ‘meaningful’ EHR use. Meaningful use includes:
  - Using a certified EHR. To date, standards for certification have not been published; the ONC is required to recommend interim standards to the Secretary of HHS by December 31, 2009;
  - E-prescribing;
  - Electronic connection in a manner that provides for the electronic exchange of health information; to date ‘connected’ standards have not been defined;
  - Submitting information specified by the Secretary, on clinical quality measures; to date, such specified measures have not been published by the Secretary.

ARRA Context

• The Health Information Technology for Economic & Clinical Health (“HITECH”) Act titles are a significant component of the ARRA. The titles affect Optometric Doctors who by definition are “covered professionals”.
• The Office of the National Coordinator (“ONC”) for Health Information Technology is tasked with administrating $19.2B of stimulus plan funding earmarked for the development and promotion of health information technology.
• The ONC is headed by the National Coordinator, Dr. David Blumenthal, who in turn reports to the Secretary of Health and Human Services Kathleen Sebelius, a member of President Obama’s cabinet.

The team at Practice Director is working diligently to stay abreast of the latest developments in this process to ensure your regulatory needs are met through the use of Practice Director’s EHR. If you have any questions, please don’t hesitate to contact us.

Please contact us for information on our EHR Incentive Plan Savings and for more information regarding EHR Certification & Meaningful Use.

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