doctors

Study: Doctors fear how gov't will use EMRs

Anne Zieger — Sat, 05 Jul 2008 17:07:14 -0400

A new study has found that doctors are resistant to installing EMRs not only due to their financial and workflow impact, but also because they fear government will use the data to impose controls on their daily practice. The study, released by the Association of American Physicians and Surgeons, reached 400 doctors, and was designed to capture a portrait of their attitudes about HIT adoption.

According to the AAPS, 81 percent of respondents said their practice didn't use EMRs, and many respondents said that they'd rather retire in their 50s than adopt EMRs. When asked why they were not adopting EMR technology, fear of interference from government was one of the top reasons they gave, along with privacy concerns, worries about return on investment, lack of capital to acquire HIT and preference for using hand-written notes.

To learn more about the study:
- read this Healthcare IT News piece

Related Articles:
California MDs lead in EMR adoption
NY gives no-cost EMRs to some physicians
CMS to offer EMR adoption incentives
Congress holds key to EMR adoption

DEA releases e-prescribing regs for controlled drugs

Anne Zieger — Sat, 28 Jun 2008 21:05:47 -0400

After months of waffling, the Drug Enforcement Administration has finally come out with regulations that would allow doctors to prescribe controlled drugs such as opiates electronically. These regs could prove to be a turning point in the emergence of e-prescribing generally, as many physicians have complained that switching from paper for controlled drugs to e-prescribing for the others was too awkward to sustain.

The new regs are designed to fight forgery by imposing a "closed system of controls" on dispensing of controlled substances. Ideally, the new system will actually cut prescription forgery levels by helping pharmacists and DEA officials to more easily trace controlled-substance scripts to legitimate prescribers. They could also make sure that the meds get dispensed by the intended pharmacist and received by the intended patient. Of course, e-prescribing these scripts would also have the benefit of avoiding illegibly-written prescriptions, as it does for non-controlled drugs.

To learn more about the pending rules:
- read this Modern Healthcare article (reg. req.)

Related Articles:
DEA eases painkiller prescription rules
DEA may allow e-prescribing of controlled substances
DEA allows e-prescriptions for controlled drugs

Texas EMR resistance shows extent of adoption problem

Mon, 02 Jun 2008 06:59:57 -0400

If Texas is any indication, the EMR adoption movement has more problems in store than many people think. According to a new survey on the subject by the Texas Medical Association, one-third of physicians are using some form of EMR, up from 27 percent in a similar survey in 2005. However, about one-fourth of respondents said that they still have no plans to implement an EMR, the same level as the previous survey. Meanwhile, about 2 percent of respondents had used an EMR in the past, but quit, most often saying that reliability problems, difficulty in using the EMR or insufficient benefits doomed the installation.

Top vendors adopted by EMR-equipped practices answering in the survey included e-MD, used by 15 percent of respondents, followed by eClinicalWorks, with 9 percent.

That being said, those who have adopted an EMR seem to be glad they did, the TMA report said. Eight-one percent of practices with an EMR said that the system is in full use by all of its doctors. Also, roughly three-fourths of practices reported being very satisfied or somewhat satisfied with their systems. Still, even those physicians had plenty of gripes, with 27 percent saying one of the things they liked least about their systems was that costs went up without generating complimentary savings.

To learn more about the study (and other related studies):
- read this Modern Healthcare article (reg. req.)

Related Articles:
Study: Physician EMR adoption up, but systems chosen are limited
Study: EMR adoption held back by multiple issues
Study: Physicians at EMR 'tipping point'
Smaller practices still behind in IT adoption

Congress considers another HIT subsidy bill

Mon, 02 Jun 2008 06:59:56 -0400

Proposals to help doctors pay for EMRs and other cool patient care technology have bounced around the Hill for years now--but maybe this one will be the ticket. Members of the House's Committee on Energy and Commerce proposed a bill last week to help doctors pay for HIT, as well as to improve patient privacy protections. This effort would amend the Public Health Service Act to provide a roadmap for the federal government's role in healthcare IT adoption, while clarifying and strengthening patient privacy requirements.

Specifically, the draft proposal would give small group practices financial aid for acquiring healthcare IT, especially those in rural or medically-underserved areas, and provide federal subsidizes for low-interest private loans enabling HIT purchases. It also would support the development of RHIOs.

To learn more about the proposal:
- read this Healthcare IT News piece

Related Articles:
Federal bill would create HIT 'trusts'
MD group asks for federal help with EMRs
Consumer, biz groups push pro-EMR legislation
AMA endorses health IT tax credits

Case study: Hospital dumps Exchange for Linux-based clone

Mon, 02 Jun 2008 06:59:54 -0400

Taking their inspiration from the facility's doctors, the IT staffers at Moses Taylor Hospital chose a fairly significant change in direction when it came time to upgrade their messaging system. Instead of moving up from Microsoft Exchange 5.5 to a pricey current version that couldn't support growing message loads, they did something completely different. IT staffers at the Scranton, PA facility went with a Linux-based Exchange clone that they felt could support their 700 users without forcing them to learn an entirely new system.

Moses Taylor now is running Exchange clone PostPath Server on top of the Linux Centos operating system, a choice IT administrators estimate cost them 50 over buying the latest version of Exchange. That estimate doesn't even take into account the costs for maintaining and supporting Exchange, noted Frank Fallo, manager of network systems. With the switch, the hospital was able to move from three staffers to one managing email.

Yet another advantage, Fallo told Network World, is that PostPath integrates well with the existing infrastructure, communicating easily with components like Active Directory, making integration with both MS and third-party tools relatively easy.

To learn more about the installation:
- read this Network World article

ALSO NOTED: CMS official admits industry unready for NPI switchover; HHS to announce EMR demo project participants; and much mo

Tue, 27 May 2008 06:59:50 -0400

> Now, even CMS officials are admitting that the industry may not have been prepared for last week's deadline for switching over to using the National Provider Identifier for Medicare claims processing. Article

> HHS will soon announce which 30 communities it has chosen to participate in its EMR demonstration project, under which participating doctors will get Medicare incentive payments for using certified systems. Article

> Maryland-based Erickson Retirement Communities is working with three Baltimore-area health systems to create a health information exchange. Article

> A group of specialist volunteers soon plan to begin offering long-distance telemedical consultations over the Internet to physicians trapped in war zones. Article

And Finally... Want to relax, but too tired to travel? Try a 'staycation.' Article

Non-profits wondering how IRS feels about RHIOs

Mon, 19 May 2008 06:59:59 -0400

As most readers know, it took what felt like an eternity for the IRS just to come out with it and say how it felt about non-profit hospitals' plans to make EMR donations to physicians. So complex and mighty is the IRS that even its "yes" doesn't appease everybody--so its memorandum on the subject, while helpful, hasn't exactly led to a rush of free or low-cost EMR rollouts. Still, it has gotten the ball rolling.

Now, it's looking like yet another promising, if slow-moving and costly, movement could get caught up in the IRS gears. If you read the entire Modern Healthcare story excerpted below, which talks about how not-for-profits are finally starting to give away EMRs to doctors, you'll see the problem. In a small aside, the story notes that the groups behind some RHIOs have begun to ask the IRS for guidance on what they can and cannot do to build their networks.

Their worries seem more than justified. After all, if they want to put an effective health data sharing organization in place, the non-profits getting involved in RHIOs may have to give away or subsidize a few technologies. Depending on how their network is configured, it may be enough to supply EMRs and follow the existing rules--but maybe they'll need to supply additional gear and software as well. At that point, arguably, the water gets murky again.

With any luck, this issue will be addressed faster than the EMR issue was. I hold out some hope that it will, given that IRS officials (who are, after all, human) may simply feel that they've worked some of the key issues out for themselves already. But it remains to be seen.

Folks, here's hoping that one of the world's most ponderously slow agencies decides to go into overdrive this time. With many RHIOs struggling to stay afloat financially, an indefinite series of delays could be deadly. - Anne

Medical group questions pharma IT giving

Mon, 12 May 2008 06:59:56 -0400

These days, the healthcare industry has begun taking a much closer look at the gifts pharmaceutical companies give doctors. However, despite this, there hasn't been as much attention paid to "e-detailing," the giving of health information technology to physicians. Now, in an effort address yet another source of potential physician bias, the Association of American Medical Colleges has issued a report making recommendations on how such relationships should work.

Pharmas have been investing in and promoting EMRs, and distributing PDAs for a number of years. Today, they continue to spend on marketing through IT donations to physicians, with such spending continuing to grow over time, according to research by marketing TGaS Advisors.

To learn more about this trend:
- read the AAMC report (.pdf)
- read the Modern Healthcare article (reg. req.)

Related Articles:
Congress debates pharma gift disclosure
Doctors debate pros and cons of accepting drug freebies
MA lawmakers mull ban on pharma gifts to doctors
NJ mulls pharma, device maker gift reporting

Case study: NH Blue plan offers mobile EMR access

Mon, 12 May 2008 06:59:54 -0400

New Hampshire's Anthem Blue Cross Blue Shield of New Hampshire plans to begin offering physicians access to patients' electronic health records via mobile phones. The new capabilities also allow doctors to e-prescribe using the phones, as well as through any appropriate Internet connection. Available data includes both clinical data and medical histories.

The announcement comes as part of Anthem's e-prescribing program, rather than an EMR rollout. New Hampshire actually has been a hotbed of e-prescribing activity, driven in part by an Anthem initiative. Late last year, the plan partnered with the NJ Citizens Health Initiative to kick off a statewide e-prescribing program for all of the state's doctors.

To learn more about the program:
- read this Healthcare IT News piece

Related Articles:
Trend: EMR-on-cellphone interest grows
NH governor backs e-prescribing
Study: E-prescribing cuts med errors 66 percent
Ohio health system rolls out e-prescribing

E-prescribing advocates harness patient pressure

Mon, 05 May 2008 06:59:59 -0400

If vendor SureScripts gets its way, e-prescribing should develop a much higher profile among consumers, doctors and pharmacies over the next few weeks. Last Tuesday, the company kicked off what looks like a very comprehensive campaign promoting the use of e-prescribing, including virtually all of the nation's pharmacy chains and thousands of independents.

The campaign, interestingly, doesn't deluge physicians directly with pitches. Instead, it urges patients to sell their doctors on e-prescribing, helpfully providing them with a physician-oriented website (www.GetRxConnected.com) to help close the deal.

While SureScripts doesn't say as much in its announcement on the campaign (naturally), to me this suggests that the company has all but thrown its hand up in the air when it comes to recruiting physicians directly. As the company notes, only 4 percent of physicians' offices are prepared to e-prescribe, despite the fact that more than 40,000 pharmacies can accept such prescriptions.

Will patient pressure have an impact? I think so. This kind of "push" strategy can work very well in retail--even though retailers are as loathe to change their buying patterns as doctors are their practice style. While doctors aren't going to change their habits overnight, repeated patient requests will get through. After all, not only are doctors concerned about keeping patients, they're certainly capable of learning something new from them.

Besides, what else can SureScripts do? Many proven physician marketing tactics don't apply here. For example, put friendly, attractive young men and women in suits and send them to pitch doctors directly, as pharmas do with new drugs, and it'd be a big bust. E-prescribing reps would have no educational updates or samples to offer.

Now, the question is whether efforts like this can move the needle enough to make a difference. Let's see, folks! - Anne