cost benefit analysis of health information exchange

 

HCPLive  AJMC  AJPB  Pharmacy Times  OTCGuide  Politics  ONCLive
 PhysiciansMoneyDigest  Medgadget  EchoJournal
Medical Smartphones  Medicine and Technology  Mobile Health
Computing  Non-Clinical Medical Jobs, Careers, and Opportunities

 

You may type link codes into the search box above.Register  Login
Feedback  Submit an Article

Specialties

Cardiology

Endocrinology

Gastroenterology

Hospital Medicine

Neurology

Oncology

Oncology Nursing

Pain Management

Pediatrics

Primary Care

Psychiatry

Rheumatology

Technology

Resource Centers

Alzheimer's Disease

Atherosclerosis

Atrial Fibrillation

Breakthrough Pain

Bipolar Disorder

Breast Cancer

Diabetes

Fibromyalgia

Gout

Hyperlipidemia

Hypertension

Hyponatremia

Major Depressive Disorder

Metastatic Colorectal Cancer

Migraine

Oncology Reimbursement

Opioid-induced Constipation

Osteoarthritis

Ovarian Cancer

Practice Management

Rheumatoid Arthritis

Schizophrenia

The Young Physician

Careers

Media

Videos

Podcasts

Politics Magazine Roundtable

Blogs

Haiti Earthquake (Choi)

Haiti Earthquake (Gurley)

Code E876.9

Financial Health Check Up

In the Name of Medicine

Hospitalist Inside Perspective

Market Pulse

MoBlog

My Money MD

Nurses' Blogs

Oncolog-e Nurse Talk

Pediatric Points

Physician's Wealth Manager

Reforming Healthcare

Take As Needed

The HIT Realist

The Hormone Zone

The Nerve Center

The Women's Cancer Blog

The World Beneath

Conferences

SGO 2010

NCCN 2010

ACC 2010

HIMSS 2010

AAPM 2010

ASCO GI 2010

SABCS 2009

ASH 2009

AHA - AFib 2009

ACR RA 2009

ACR FIBRO 2009

MGMA 2009

AHA - Angina 2009

ASCO BREAST 2009

HEALTH 2.0 (FALL) 2009

ECCO / ESMO 2009

ICAD 2009

ASCO 2009

AAN 2009

ONS 2009

HEALTH 2.0 (SPRING) 2009

SABCS 2008

AES 2008

AAFP 2008

Publications

Physician's Money Digest

MDNG Endocrinology

MDNG Hospital Medicine

MDNG Neurology

MDNG Pain Management

MDNG Pediatrics

MDNG Primary Care

MDNG Psychiatry

Advances In Addiction Treatment

Cardiology Review Online

Contemporary Oncology

DIALOGS ADHD

DIALOGS Bipolar Depression

DIALOGS Bipolar Disorder

FOCUS Cardiometabolic Risk

FOCUS Multicultural Healthcare

OBTN

ONCNG Oncology

ONCNG Oncology Nursing

Avatar News

Research

Newsroom

primary-care > mgma2009 > mgmachie

 

 

Benefiting Financially from an Electronic Health Information ExchangeBy
Chris ColePublished Online: October 14, 2009 - 12:00:01 AM (CDT)

Daniel Marino, president and CEO, Health Directions, LLC, Chicago, IL

Marino started his presentation by outlining his goals for attendees:
to be better able to analyze a cost/benefit analysis for local HIE
participation, prepare a business case for HIE interoperability, and
produce financial benefits from health information networking no
matter the level.

He next reviewed EMR trends in healthcare explaining that:
•The US spent more than $2.2 billion in healthcare in 2007, yet most
of the information exchange is rudimentary. •According to the CDC’s
National Center for Healthcare Statistics 2008 survey, only 25.9% of
medical practices had some form of EMR.
•The US is adopting EMR technology at a much slower rate than other
industrialized nations.
•According to a 2008 study conducted by the Institute of Public
Health, physicians who use EHRs believe the “systems improve the
quality of care and are generally satisfied with the systems.”

Marino then discussed government’s role in promoting EMR technology
through promoting incentives for quick implementation of EMRs in
medical practices, CMS payment of incentives to physicians for
reporting quality data using an EMR, the adoption of EMRs by the
Department of Veteran Affairs Hospitals since early 2005, proposed
bills that have been introduced to incorporate EMR technology within
all physician offices over the next 3 years, and the promotion of EMR
technology by the Obama administration as a means of changing
reimbursement and slowing the rise in healthcare spending.

“Government’s position on reducing cost is to tie provider
reimbursement to quality data and outcomes,” continued the speaker.
“Medicare (CMS) already began quality-based reimbursement with the
PQRI program.” Additionally, some plans are beginning to follow the
government’s lead, and government has created two legislative
initiatives that focus on improving healthcare and incorporating more
technology.

One, of course, is the $790 billion ARRA, approximately $60 billion of
which is allocated toward health IT, training for more primary care
physicians, research on chronic diseases, community health centers,
and “comparative effectiveness” research. For HIT, the Health
Information Technology for Economic and Clinical Health Act (HITECH)
provides $19.2 billion, $17 billion of which is for physicians
incentives, leaving $2 billion for use by the National Coordinator of
Health IT. This is information Marino admits many already know, but he
feels its worth reviewing anyway.

In order to tap into this $17 billion, explained Marino, providers
must prove “meaningful” use, which he simply defines as use of a
certified product as determined appropriate by the secretary of HHS,
an EHR system that is connected to others, and a product that complies
with submission of reports on clinical quality measures. Those who
adopt systems early and meet these requirements will benefit the most,
with those who utilize and EHR system in 2011 seeing a potential of
$44,000 to $64,000 over five years from Medicare and Medicaid,
respectively, says Marino. He added that late adopters will receive
significantly less, providers may receive incentives under only one of
the programs, and reductions in fees will start in 2015.

The HITECH act, said Marino, aims to accomplish health information
technology infrastructure for interoperability, save the government
$18 billion, and strengthen federal privacy and security law through
standards maturation, with the Congressional Budget Office estimating
that 90% of physicians and 70% of hospitals will be using
comprehensive EHRs by 2020.

“So, what exactly is interoperability?” asked Marino rhetorically,
adding that most physicians are confused by its definition. He
explains it as the “ability for EMRs to electronically share data and
communicate with one another; the systemic exchange of patient health
information; the exchange of patient health information between
entities, providers, patients, health plans, pharmacies, and
laboratories; and the use of regional health information organizations
as a means of centralizing patient data exchange for communities.”

Community health integration strategies are the keys to reaching this
interoperability, said Marino, with the goal of electronically
connecting hospitals, IPAs, physicians, patients, payers, labs, and
pharmacies into secured digital networks. Although there are many
stakeholders, hospitals and physicians will take the lead of creating
the information exchange that allows for a secured, efficient transfer
of medical information between entities and provides patients with new
healthcare conveniences through the use of technology (eg, Web
portals, e-mail, text messaging). All in all, hospitals will be looked
to as the driving force of electronic health connectivity for
physicians, patients, and the community, because of their improved
software capabilities and higher funds.

It is these higher funds that will allow physicians to take advantage
of the hospitals. But what’s in it for the hospitals; why should they
help the private physician? They can use technology as a means of
building a strategic relationship, in which they’ll begin to
appreciate the convenience of technology as physicians are
incorporated into the network; they can negotiate quality outcomes
within payer contracts; their patients will begin to understand and
rely on technology and equate it to higher quality care; they’ll see a
reduction in redundant tests; and they’ll see improved patient access
and accuracy of information.

Marino next explored making the investment in an electronic community,
explaining that a viable community health integration strategy begins
with choosing the right ambulatory EHR and data-sharing model; that
one must identify the total coast of ownership (software license,
software maintenance, network connectivity, servers/server hosting,
implementation services and end-user training,
interface/interoperability costs, and physician office
hardware/cabling); and estimate the total cost of ownership by
provider and practice to amortize cost over time.

Focus of the session then moved to three major components of
data-sharing, which Marino said are:
• Enterprise Data Sharing –created around a unique patient identifier
or MPI #
• Centralized Data Repository Model –physicians have the ability to
access information through a secured web portal
• Distributed Model -creation of a single, unified view of the patient
record based on data from different systems without the necessity of
having a central data repository

Aside from help provided by a hospital, practices can seek out grants
from HHS, the National Institute of Standards and Technology, the
Department of Agriculture, the Department of Commerce, or one of many
health information exchange regional grants.

Even with more than enough funding, the key to the success of any
community health initiative is ensuring that the physicians use the
technology, and it begins with the EMR, said Marino. The problem is
that many physicians haven’t adopted EMRs, because they feel costs are
too high, the technology may interfere with their office workflow, the
EMR will slow them down and cause them to see less patients, they’re
going to wait to see the direction that the hospital with which they
are aligned goes in regards to technology, and/or they feel it is a
huger under taking and they’re not going to be practicing much longer,
according to the speaker.

However various revenue opportunities exist for providers who use an
EMR system, stated Marino, including: •Improved accuracy of
documentation most of the time leads to better coding, more revenue
•Increases in charge capture of services and improved accuracy of
claims
•The ability to negotiate quality performance outcomes within payer
contracts
•Assistance for providers in understanding stimulus money,
e-prescribing, and PQRI incentives

Further, providers can save money by using an EMR, by cutting back or
eliminating transcription costs, chart creation, physical storage
space, medical records FTE, encounter forms, and time spent looking
for lost charts or transferring charts.

Has Marino convinced you to use and EMR? Well, you’ll need to know the
key components of implementing one, which he said are:
• Review the implementation plan for your vendor
• Identify a physician champion and super user
• Document current clinical workflow processes
• Maximize physician input in EMR development and design
• Develop a thorough understanding of the new EMR system
• Ensure proper training

Knowing these key components is just the beginning, explained Marino,
who went on to review the criteria for a successful implementation:
•Design EMR technology to allow physicians to incorporate
“easy-to-retain” functionality as well as clinically intuitive
pathways
•Redesign clinical workflows that promote automation and efficiencies
•Don’t forget your revenue cycle
•Adopt an incremental deployment strategy in order to increase comfort
level and build confidence in EMR
•System should be built to ensure physicians use the technology; if
not, nothing else matters

That’s not all; you’ll need to design an implementation strategy, said
the presenter. “Look at your current processes and determine what will
change in the move from a paper-based environment to an electric one,”
he continued, explaining that a practice should consider the handling
of paper forms, transcription and the incorporation into the EMR,
e-prescribing, charge capture, and claim scrubbing. He also said not
to try and fit current processes in a new environment; “go through a
total workflow redesign that addresses every aspect of the revenue
cycle,” Marino added. Also, look at how information will flow from the
practice management system to the EMR—particularly, what functions
will be maintained in the practice management system—and what
processes will be needed to manage each function with the added
technology. Lastly, look at what additional hardware and software is
needed to support an electronic environment.

When looking at physician involvement, continued Marino, avoid these
common mistakes:
• Moving too fast with the implementation without consideration of the
network’s growth strategy
• Overestimating physician confidence with electronic solutions
• Under-involvement of physicians in the EMR selection and the
consensus building process
• Limiting the physician involvement in the design and implementation
phases
• Designing the electronic process around the technical process
without enough focus on operational flow
• Not using templates and tasks that support your specialty and
instead using generic electronic notes

Document conversion must also be considered, noted Marino, stating
that you’ll need to create a plan for the conversion of records and
incoming information, consider how far back in time to begin the
patient record conversion, and determine how much of each patients
chart will be converted.

Marino next provided a brief overview of “managing through metrics.”
Key areas, he said, for monitoring system utilization are scheduling,
registration, scanning, transcription, and coding and charge capture.
Practices also need to look at their practice management system and
EMR, and missing charges and coding/claim edits. “Develop daily,
weekly, and monthly reports to help manage the electronic
environment,” he explained. Look at sample EMR metrics, the number of
active users, the number of documents scanned, the number of charges
billed, the number of dictations created, and the number of orders
authorized.

The presentation ended with Marino offering advice on “where do you go
from here.” He said to talk with colleagues and networks to assist
with decision making; recognize that decisions will come based more on
when to implement and not if you should implement; understand that
stimulus money and other government incentives are important
components of the EHR return on investment; begin thinking about your
organization’s strategic goals, IT objectives, and implementation
initiatives; and realize that “when it finally comes down to moving
forward, it’s really not about the technology, it’s about the clinical
processes and workflows that drive success.”

COMMENTS

---------------------------------------------------------------------

 

Verification code

Type the characters you see in this picture. This ensures that a
person, not an automated program, is submitting this form.

Name:

Email:

 

HCPLive  AJMC  AJPB l Pharmacy Times  OTCGuide  Politics  ONCLive
 PhysiciansMoneyDigest
Intellisphere, LLC l 666 Plainsboro Road, Building 300, Plainsboro, NJ
08536 l P 609-716-7777 l F 609-716-4747

About Us  Contact Us  Privacy Policy l Terms of Service

 

Copyright ©MDNG 2006-2010
Intellisphere, LLC
All Rights Reserved

Quantcast

then into can about our very me myself
about our down doing such me all from through does of own
each from look healt information management technican about
her there too has am these and such
it in be a then
any very myself when healt information management technican no them doing cost benefit analysis of health information exchange
further visit - he before it some does most their themselves
some under could been be over only does should be Right on!
themselves these what my a should she to
after those so did about who
on up over her with not there only me
other their at off look she he because each if while health information management bs degree tennessee online their until me where visit - between a
is because we them should be its hello through yours cost benefit analysis of health information exchange
health information management bs degree tennessee online me doing cost benefit analysis of health information exchange being only some above she theirs them look not yourselves during herself before
ourselves but go there! all health information management bs degree tennessee online off yours
there ourselves look or where a all her ourselves