medical practice

NAHIT name game gives some vendors a headache

Mon, 09 Jun 2008 06:59:55 -0400

In theory, it doesn't make sense to move ahead with major IT initiatives until the industry has at least some clue as to how to define key terms. However, a recent effort by the National Alliance for Health Information Technology (NAHIT)--particularly in defining the difference between EMRs and EHRs--seems to be creating as many problems as it solves. Over several months, NAHIT came up with definitions for key terms in HIT, including EHR, EMR, personal health record, health information exchange and regional health information organization. Most notably, as NAHIT defines things, an EMR is a record used internally in a medical practice that can't share information with other practices, while EHRs can do so.

The problem with this is that NAHIT seems to have defined some vendors right out of their marketing position. There are several companies that use the term "EMR" to define themselves, such as NextGen Healthcare Information, and have gotten their interoperability certification from the CCHIT. If they have to go back and rebrand themselves as an "EHR" they'll be a bit annoyed, to say the least, officials note.

To learn more about the terminology dispute:
- read this Modern Healthcare piece (reg. req.)

Related Articles:
CCHIT makes EMR certification simpler
CCHIT gets official, approves new vendors

ALSO NOTED: Telemedicine system links India, Ethiopia;KY county lets EMTs send patient data wirelessly; and much more...

Mon, 07 Apr 2008 06:59:50 -0400

> Here's an interesting telehealth project; a new pilot has linked hospitals in rural Ethiopia with India's leading cardiac institute. Article

> Officials in Louisville-Jefferson County, KY have bought a $2.1 million electronic patient care recording system that allows its EMTs to capture patient info digitally and wirelessly transmit the data to hospitals. Article

> A California medical practice is rolling out an EMR system with help from the National Committee for Quality Assurance. Article

> A California multi-site primary care and specialist network has set plans to offer patients a set of online administrative tools, including a PHR. Article

And Finally... Want to see what an EMR looked like circa 1961? Check this out. Video

HHS head encourages payers to demand e-prescribing

Mon, 26 Nov 2007 06:59:57 -0500

It's just a blog--but look who's blogging! In a recent post, HHS Secretary Mike Leavitt has suggested that not only Medicare and Medicaid, but also private payers, should demand that providers use e-prescribing technology. "E-prescribing needs faster implementation," Dr. Leavitt writes. "...Large health care providers, including Medicare and Medicaid, need to move toward making it a mandatory part of medical practice soon."

In his post, Leavitt compared the problem in promoting e-prescribing use to the issue faced by the state police department when he was governor of Utah. After finding out that key data was being buried in paperwork, he required officers to learn to use a laptop to transmit key reports, despite the fact that some barely knew how to use a keyboard. He's now suggesting that similar pushiness is called for with physicians.

Leavitt made his comments after meeting with the American Health Information Community last week, where he serves as chairman. AHIC has just begun drafting a recommendation to the Secretary's office on making e-prescribing mandatory for Medicare.

To learn more about Leavitt's comments:
- read this Government Health IT article

Related Articles:
SPOTLIGHT: Physician IT adoption still poor--so what next? Report
Leavitt adds teeth to HIPAA enforcement. Report
HHS promotes international EMR standards. Report
HHS asks employers to push shared HIT standards. Report

Healthcare IT's digital divide

Mon, 30 Jul 2007 06:59:59 -0400

So, apparently IT investment can have measurable clinical results, according to the latest from the Integrated Healthcare Association.

I'd imagine part of this effect isn't directly due to IT use. Instead, I'd think groups that invest heavily in IT also have the resources to closely supervise, fund and monitor internal healthcare quality. But I also accept the IT investments did play some role on their own.

However, it seems these benefits are unlikely to trickle down to small groups. With federal and state efforts to foster IT adoption lacking teeth--and more importantly, cash--smaller practices aren't likely to get the boost they need in the near future. Increasingly, I believe we're going to see a "digital divide" in medical practice which grows steadily greater as the larger groups profit from IT--and the smaller groups lose traction without it.

Without a doubt, trade groups can help close this divide. (Consider the efforts of the Massachusetts Medical Society, which has struck a deal giving its members EMR discounts.) But they can only do so much.

I believe it's going to take the clout of the federal government--CMS, perhaps?--to help smaller practices get on board. And officials had better get serious now. As the medical digital divide gets broader, it will create structural changes in the competitive landscape (think "the poor get poorer") which may doom IT adoption for years to come.- Anne

Big medical practices want more pay for IT

Sun, 25 Feb 2007 19:01:37 -0500

The American Medical Group Association, which represents large practices like the Cleveland Clinic, wants to see the government help to pay for their growing investments in cutting edge technologies like EMRs. The AMGA is asking CMS to take into account the extent to which it spends on IT and coordinated care by, for example, raising payments per beneficiary or creating new CPT codes taking these measures into account.

But wait--aren't these investments at the core of what these large do to compete? So wouldn't that put government in the business of financing an IT arms race among the largest players in the medical practice world? Maybe the government should indeed pay for IT investment, but methods that favor the groups who already have the capital might (justifiably) raise a few hackles. If CMS or lawmakers take this on, they're going to have to do a real balancing act.

To get more background on the AMGA's proposal:
- read this article from Modern Physician

Case study: IT use keeps solo doc afloat

Sun, 25 Feb 2007 19:01:35 -0500

Dr. Gordon Moore was unhappy with the high volume of patients he was required to see as a staff physician in a hospital-owned medical practice--30 plus a day, each of whom only got 15 minutes of his time. Unwilling to keep that pace up, in 2001 Moore took out a $15,000 business loan and opened his own one-man practice. He's not alone. While no one has exact statistics, a growing number of doctors are following his model, building tiny but high-tech practices that allow them to work on their own terms.

Because he was battling to keep expenses low, he decided not to hire nurses, receptionist or medical billing pros. Instead, he relies largely on a mix of practice management software, e-mail, e-prescribing, e-faxing and annual patient wellness surveys conducted via the Web to sustain his practice. Thanks to such automation, and scrimping on equipment and office space, Moore calculates that overhead makes up 35 percent of his revenue, as compared with 60 percent for other small PCP practices. He's also been able to keep patient visits down to a modest 12 a day.

To find out more about this "micropractice" model:
- read this Wall Street Journal article (sub. req.)

Related Article:
Consumer-driven healthcare shifts MD tech needs. Report

Editor's Corner

Sun, 26 Nov 2006 19:01:39 -0500

I'm delighted to hear that doctors are taking e-care seriously (see below). Like most of you, I've been online for more than ten years, so my attitude is, "Hey, it's about time!"

However, if I were advising a smaller medical practice, I still might not recommend that they jump on board. Offering email-based care sounds great and certainly offers consumers a great deal of convenience, but implementing such a service is trickier than it sounds. Lots of questions come up. Should practices roll out their own Webmail system, and if so, how do they figure out how much to spend? Should they pay for their own development work, or find an ASP offering e-care services? What kind of investments are reasonable? And perhaps most importantly, given HIPAA issues, how do they judge whether security is strong enough without a full-time IT staff member on board (as is so often the case)? Given these types of issues, it's certainly no surprise that smaller practices are still behind on most types of IT adoption.

I don't know about you, but I send standard, unencrypted email to doctors whenever I get the chance. The thing is, I know it goes out in the clear, and govern myself accordingly. I'll wager that most consumers--and doctors--aren't aware that their intimate medical conversations could be sniffed, read and distributed. Doctors might include privacy warnings in each and every email communication they send out, but consumers might very well tune them out.

Given these problems, I expect to see an e-care security breach give rise to a HIPAA suit before e-care matures as a service. (Any attorneys reading this? What do you think?) - Anne

SPOTLIGHT: Making EMRs fit your workflow

Sun, 29 Oct 2006 19:01:32 -0500

If EMRs force doctors to make unnecessary moves or click too many times, it undercuts their value a great deal. In fact, given the amount of time they waste, extra clicks can cost hospitals and medical practices meaningful amounts of money, as much as $1,275 per 3.5 FTEs each year in a typical medical practice, writes Dr. Michael McCoy, EVP and chief medical officer of EMR vendor digiChart. If fact, if EMRs continue to be awkward to use, practices and hospitals may have to pay doctors a differential just to get them to use the system, he suggests. Article