Just a reminder to anyone that has their information on Google Health that they had announced that they will be discontinuing their service from January 1st, 2012.
To read more about this, I have shared the link here on this post.
Month: November 2011
Testing Strategies during an EHR Implementation
You will certainly be ‘tested’ during Unit and Integration Testing time during an EHR implementation.
The keys to a successful Testing Cycle is of course great test scripts based on functional requirements that the users have shared with you at the beginning of the project and following them. Having teams that have at least some experience with the software and it’s workflow is ideal and have an understanding of what should happen on each and every screen, such as going through a Progress Note.
Try and understand what has gone wrong from previous experiences; whether it is of known bugs (you may have to work on this and try and get it out of the vendor as I am sure they won’t want to admit that there are any “bugs” at all) or some user forced errors. It is not a great distinction to be the first to find out about an bug in the system. Identifying dates for fixes as well as workaround if issues are discovered is an effective plan for action on any identified workflow issues. Additionally, always assume that the software will not perform the way you think it will and perform a stress test to try and simulate a “day in the life” environment as much as possible. Having 2 to 3 trial runs would be ideal. If you have a major code change, a strong suggestion would be to do “regression testing”, which checks to see if previously known bugs return after a patch is put in place and possibly interferes with previously written code. Summing it all up really is that the 3 most important words in prior to an EHR/EMR implementation Go Live are “Test, test, test!”
5010 statement shared across HIMSS Chapters today
ICD-10 Stakeholders Members, P.O. Boxes No Longer Permitted in Billing Provider Address in 5010 Transactions Jan. 1
Do you use a P.O. Box or lock box address as you billing provider address to receive payments? If you submit claims electronically, you will be required use only a street address or physical location as the billing provider address. Continuing to report a P.O. Box in the billing provider address field will cause your claims to reject. Under the Health Insurance Portability and Accountability Act (HIPAA), all physicians and other health care providers that submit claims electronically are required to transition to the Version 5010 transactions by Jan. 1.
One of many data reporting changes in the Version 5010 transactions is the requirement to report only a street address or physical location as the billing provider address. Practices that wish to continue having payments sent to a P.O. Box or lock box will report this address in the “pay-to” address field. You may need to work with your practice management system vendor, billing service, or clearinghouse to have this address change made for your claims. Talk to them today to find out if a change is needed and when it will be done. This work needs to be done prior to Jan. 1 to prevent claims rejections and interruptions in your cash flow. Visit www.ama-assn.org/go/5010 or www.cms.gov/Versions5010andD0 for more information on data reporting changes in the Version 5010 transactions and to prepare your practice for the Jan. 1 deadline.
Mobile Device Strategy for EHR
“Let’s have a Device Fair!” or “Let’s get a few devices together and let the physicians make an educated choice.” Typical conversations during an EHR implementation or upgrade or migration.
I think quite frankly that physicians these days want to have “an app for it” if they are at all IT savvy and want that app to be on an Apple iPad. Unless the public starts to migrate away from Apple as the legion of fans of the late, great Steve Jobs possibly move their allegiences, I think Apple’s iPad will rule the roost for at least a few more years. Blackberry has lasted for about close to a decade and is only waning now (except for die-hard “keyboard vs. touch screen” fans).
(Note to self: Remember the function of the right click…iPads can’t right click yet…remember that when your physician wants to use it to complete their patient progress notes).
What is good strategy that has been used across healthcare organizations to purchase, develop policy, adopt and monitor compliance? I know that HIMSS had a great webinar on November 16th, 2011 on this.
Everybody at a hospital (especially Physicians) love their mobile devices as they have become the preferred in the healthcare domain. These have their pros and cons as anything, such as security for instance. When a physician receives an image sent by a patient of their tumor on their mobile device (via text), what should be done? Is this a breach of HIPAA? I have heard arguements for both sides (not that I necessarily believe the arguements for that). If the physician’s device is lost and data is breached, this can affect many individuals at once. I think that the focus should be on your overall device and computer usage policies and compliance to those policies that will be the clincher and how you can maintain those policies effectively, especially when the devices go offsite. Satisfying evolving regulatory policies, education on proper usage and risk mitigation will drive the day.
CHCIO Certification
Yesterday, one of the CIO’s that I have the honor of knowing mentioned to me that she had taken and passed the CHCIO (Certified Healthcare CIO) certification. I congratulated her and felt it was great achievement. The CHCIO certification is granted by the College of Healthcare Information Management Executives.
I believe that this will set apart healthcare CIO’s from other industry CIO counterparts to deal with the unique challenges that healthcare has in today’s environment.
The stress of an EHR implementation
We’ve all known that projects can be stressful at times and that patient safety and lives are affected when something goes wrong. Read these 14 tips that might help you manage your life more effectively. I know that “Time Management” is the most difficult aspect of life to manage. Maybe bending the fabric of time (watch Nova episode during week of November 7th, 2011) will give you some relief. if you can’t bend time, then check out the link below and just maybe, dealing with all those irritating issues during your EMR project (vendors, developers, physicians, project managers, testing, testing and oh and more testing) may be less of an irritant that you thought.
http://www.datacenter-edge.com/content/fourteen-tips-managing-work-related-stress?slide=1
Big Bang EHR Implementation vs Phased Approach
I sat in on a great webinar from HIMSS the other day that covered an EHR implementation by a hospital system and it’s consulting partners Massachusetts. They had 18 physician pratices that covered areas from Primary Care to Neurosurgery and they went from a paper to a paperless EHR solution. They spoke about how they went in for the Big Bang approach in their implementation and were then in their 9 day after go live. So far so good from what I heard. I wonder if that will continue.
Another great organization here in Columbus, Ohio recently did the same with their EHR implementation. I’m waiting to hear about that, hopefully during next year’s CSO HIMSS conference (if I can convince them to speak about it). Yes, the big bang approach can work folks!
If there is the big bang EMR approach, it forces everyone, physicians, clinical staff, administration and IT to get on the same page and fast, otherwise there could be the ability to continue with the old system and that would develop into political brinksmanship. Nobody wants that. There’s no political wrangling in healthcare!
While this approach can get the “rigors” of implementation over and done with, (pull off that bandaid at one go) the compressed timeframe may have long term repurcussions in terms of support. An example of this could be a more phased approach towards physician clinical/progress note development. Physicians may not always have the ability to document all of their information at a few sittings to develop a somewhat comprehensive note and that will lead to high frustration with the system. A phased project approach can reduce that frustration and EHR adoption rates could be higher.
Awesome communication is the essence of a good EHR Project
The word “Awesome” gets bandied about quite a bit (usually by surfers in California if you believe the movies), but based on my experience, the word is appropriate when it comes to any project, but EHR more so than ever. The inevitable question may arise? Why awesome?
If you think about it, would you want to have a physician that treats you not focused on you when he or she is with you in the examination room? Physicians have a number of things always circulating in their minds and in order to stay on top of everything that is going on, short, concise and easy snapshots are what they need to have.
Also, make them your ally. Physicians are already wary as it is about the benefits of IT in their workplace and that too the EHR, and it will not help your cause if you come across as hardline IT with them. Make it a sale. Go into any meeting with a physician with the thought that they will be skeptical about change and find a way in which to hear them out. The art of listening will do you good. Trying to explain the benefits of the EHR in any first meeting will not get you far (unless your physician has had experience and then they may tell you all of the headaches they had to endure such as documentation taking longer, not having any weekends left into their already non-existent ones.
One of the ways that I was able to keep everyone in tune with the message was to have regular “scrums” during the project. We would “sprint” from scrum to scrum and would identify changes or lessons learned from the sprint. This really helped the team stay focused and was instrumental in keeping everyone on track with our deliverables. Of course, it could all go out of whack if an emergency plastic surgery ended up happening and the physician was called in when he needed to meet with the development team (um….we won’t go there), but overall, the scrums worked 90% of the time for our purposes.
One of the physicians that I worked with, said she enjoyed cooking Indian food and I, being the cook that I am, said I would assist her with recipes and gave her ideas to spice up her dish. Needless to say, ice-breakers to facilitate easier communication may come from the most surprising sources. Watch out for them!
CMS Medicare & Medicaid EHR Incentive Programs
For those of you who want to get a snapshot of the timelines involved with CMS, I have added what has been published by them. Feel free to update me if I have missed anything:
- The Fall of 2010, Certified EHR technology became available and listed on the Office of the National Coordinator (ONC) site.
- January of 2011, registration for the EHR incentive program began. Additionally, for Medicaid providers, States could launch their programs if they chose to.
- In April of 2011, attestation for the Medicare EHR Incentive Program began.
- In May of 2011, EHR incentive payments began.
- In the fall of 2011 (November 30th to be precise), it is the last day for eligible hospitals and Critical Access Hospitals (what are these?…coming soon) to register and attest to receive an incentive payment for FFY 2011.
- During the early part of the year, winter of 2012 (Feb. 29th), it is the last day for Eligible Professionals (EPs) to register and attest to receive an incentive payment for CY 2011.
- 2014 is the last year to initiate participation in the Medicare EHR/EMR Incentive Program. DONT MISS THIS DATE.
- In 2015, Medicare payment adjustments begin for elegible physicians and hospitals that are not meaningful users of EHR/EMR technology.
- 2016 is another BIG year. It is the last year to receive a MEDICARE EHR incentive payment and also the last year to initiate participation in MEDICAID EHR Incentive Program.
- 2021 is the last year to receive the MEDICAID EHR INCENTIVE PAYMENT.
Hopefully this timeline will help in understanding what healthcare provider organizations and professionals face over the next few years. Saddle up!
Why is everyone talking about “Meaningful Use” and what is it?
CMS has the answer below. No point reinventing the wheel on this one. Better to get it from the horses mouth.
The American Recovery and Reinvestment Act of 2009 specifies three main components of Meaningful Use:
- The use of a certified EHR in a meaningful manner, such as e-prescribing.
- The use of certified EHR technology for electronic exchange of health information to improve quality of health care.
- The use of certified EHR technology to submit clinical quality and other measures.
Simply put, “meaningful use” means providers need to show they’re using certified EHR technology in ways that can be measured significantly in quality and in quantity.
Healthcare Interoperability 