THE EHR PROGRAM YOU NEED

 

 

 

 

 

THIS JUST MIGHT BE THE EHR
PROGRAM YOU NEED TO NAVIGATE
OBAMACARE REQUIREMENTS

 

"The Obama administration maintains that pushing hospitals and physicians to adopt electronic medical records will improve efficiency, increase patient safety, and reduce health care costs. But as more providers transition to EMRs, there has been an unexpected consequence: Billions of dollars in higher costs for Medicare, private insurers, and patients. EMRs may ultimately make health care provision easier, but they also make the process simpler for hospitals and physicians to bill more for their services, regardless of whether they provide additional care. According to the Centers for Medicare and Medicaid Services, cloning, upcoding, and overcoding from template-generated records are some of the abuses that have resulted from the change to EMRs," states Kenneth Artz, a freelance reporter for The Heartland Institute based in Dallas, Texas.

 

Whether these noises over EMR requirements are valid, or not, required EMR is here to stay.  We just have to navigate through the process, learn from our mistakes, and move forward along the internet  highway to a bright new future for practicing medicine.  I believe and trust that using EMRs will actually help the medical community deliver much better quality care than ever before.  Not withstanding the stimmulis incentive, the costs, both monetarily and logistically, of initiating an all inclusive EMR  look to be absolutely cumbersome and downright scary to what I call many chart-in-hand "Paper Physicians" who might actually be thinking of retiring rather than attempting the big switch.

 

EXAMPLES WE READ ABOUT 

 

Dr. Samuel Berkman planned to retire from his hematology practice once medical records went digital: “I figured I didn’t want to be bothered with this. For many people in my generation, we didn’t grow up on computers. The whole thing kind of scared me.” ..........until he found an EMR Program that enabled him to accomplish the whole transition and without paying a dime, he got his $18,000 stimulus check and “a new lease on life” for his practice.

Dr. David Wyatt manages his three facility practice in northern Atlanta with a flexible EMR, allowing him to access patient information anytime, anywhere.  "Our practice consists of three offices in the northern Atlanta area.  I have a total of 10 staff including two physicians, 5 medical assistants, a business manager/partner as well as a registered dietician who all access patient charts.  We deal with "walking-well" patients who are seeking weightloss, dietary, exercise and/or metabulism consultation. We see 95% adults. I have used Nextgen as well as PIVOT EMR systems in my previous work and when this business venture began, I wanted to find a system that could be customized to this particular type of practice, have low up-front costs, have easy set up, as well as a responsive support team. There are Bariatric (weight loss) specific EMRs on the market – costing between $7,500 and $25,000. But these were not internet based (ASP) and we did not want to maintain a server nor take on the issues of patient data safety and maintaining this data. We had the issue of patients needing to go in between offices and their charts not being accessible except by fax. Now all our charts as well as notes, medications, phone messages, and schedules are available though our EMR at any location. We have had great feedback from patients. In addition, our EMR helped with our ability to train new employees and establish a standard protocol for all the offices."

After trying out another EMR, Dr. Andrew Bronstein turned to this EMR for his Las Vegas surgical practice and quickly discovered more than a great price tag. "This is absolutely an invaluable software product, from how easy it is to implement to how robust it is compared to other EMRs that cost tens of thousands of dollars."  He was was originally looking for any EMR that could manage his surgical practice: “I had invested in an electronic health record system after paying approximately $60-70,000 in hardware and software. The install team didn’t show up on day two, and then I found out that the company went bankrupt."

This system, however, was very impressive as he went ‘Live in 5’ minutes and because it is an internet based system that they are changing at all times, he didn't have to buy a license fee for one year and then update it every year.

The system all of these physicians found to be robust, end-user friendly, malliable, simple to use and highly cost-effective is called Practice Fusion! You'll immediately appreciate the benefits of using Practice Fusion's free (YES....FREE), web-based solution. Their user-friendly electronic health records system can be activated in less than five minutes, eliminating the difficult conversion process that has become industry standard. Practice Fusion stands out in a marketplace dominated by expensive, complicated and ineffective EHR systems. We wholeheartedly recommend PRACTICE FUSION every time we get to all of our clients and cannot wait to see their fears fade away and excitement take it place as they begin to use it!

See how Healthcare Business Management can guide you into the future of EMR with our recommendations and experience.

 

What Can Healthcare Learn From The Cheesecake Factory?

 

Associate professor of surgery at Harvard Medical School and journalist, gives his perspective on how chain restaurants could provide key insights to delivering efficient and cheap healthcare.





“It’s easy to mock places like the Cheesecake Factory—restaurants that have brought chain production to complicated sit-down meals. But the ‘casual dining sector,’ as it is known, plays a central role in the ecosystem of eating, providing three-course, fork-and-knife restaurant meals that most people across the country couldn’t previously find or afford. The ideas start out in elite, upscale restaurants in major cities. You could think of them as research restaurants, akin to research hospitals. Some of their enthusiasms—miso salmon, Chianti-braised short ribs, flourless chocolate espresso cake—spread to other high-end restaurants. Then the casual-dining chains re-engineer them for affordable delivery to millions through a 'command center' recipe production protocol. Does health care need something like this?”

Armin Ernst has big plans for "a rollout of full-scale treatment protocols for patients with severe sepsis, acute respiratory-distress syndrome, and other conditions; strategies to reduce unnecessary costs; perhaps even computer forecasting of patient volume someday" and are "already extending the command-center concept to in-patient psychiatry. Emergency rooms and surgery may be next. Other health systems are pursuing similar models. The command-center concept provides the possibility of, well, command.

Today, some ninety 'super-regional' health-care systems have formed across the country—large, growing chains of clinics, hospitals, and home-care agencies. Most are not-for-profit. Financial analysts expect the successful ones to drive independent medical centers out of existence in much of the country—either by buying them up or by drawing away their patients with better quality and cost control. Some small clinics and stand-alone hospitals will undoubtedly remain successful, perhaps catering to the luxury end of health care the way gourmet restaurants do for food. But analysts expect that most of us will gravitate to the big systems, just as we have moved away from small pharmacies to CVS and Walmart.

Already, there have been startling changes. Cleveland Clinic, for example, opened nine regional hospitals in northeast Ohio, as well as health centers in southern Florida, Toronto, and Las Vegas, and is now going international, with a three-hundred-and-sixty-four-bed hospital in Abu Dhabi scheduled to open next year. It reached an agreement with Lowe’s, the home-improvement chain, guaranteeing a fixed price for cardiac surgery for the company’s employees and dependents. The prospect of getting better care for a lower price persuaded Lowe’s to cover all out-of-pocket costs for its insured workers to go to Cleveland, including co-payments, airfare, transportation, and lodging. Three other companies, including Kohl’s department stores, have made similar deals, and a dozen more, including Boeing, are in negotiations. Big Medicine is on the way.

Reinventing medical care could produce hundreds of innovations. Some may be as simple as giving patients greater e-mail and online support from their clinicians, which would enable timelier advice and reduce the need for emergency-room visits. Others might involve smartphone apps for coaching the chronically ill in the management of their disease, new methods for getting advice from specialists, sophisticated systems for tracking outcomes and costs, and instant delivery to medical teams of up-to-date care protocols. Innovations could take a system that requires sixty-three clinicians for a knee replacement and knock the number down by half or more. But most significant will be the changes that finally put people like John Wright and Armin Ernst in charge of making care coherent, coordinated, and affordable. Essentially, we’re moving from a Jeffersonian ideal of small guilds and independent craftsmen to a Hamiltonian recognition of the advantages that size and centralized control can bring.

 

Yet it seems strange to pin our hopes on chains. We have no guarantee that Big Medicine will serve the social good. Whatever the industry, an increase in size and control creates the conditions for monopoly, which could do the opposite of what we want: suppress innovation and drive up costs over time. In the past, certainly, health-care systems that pursued size and market power were better at raising prices than at lowering them.

A new generation of medical leaders and institutions professes to have a different aim. But a lesson of the past century is that government can influence the behavior of big corporations, by requiring transparency about their performance and costs, and by enacting rules and limitations to protect the ordinary citizen. The federal government has broken up monopolies like Standard Oil and A.T. & T.; in some parts of the country, similar concerns could develop in health care.

Mixed feelings about the transformation are unavoidable. There’s not just the worry about what Big Medicine will do; there’s also the worry about how society and government will respond. For the changes to live up to our hopes—lower costs and better care for everyone—liberals will have to accept the growth of Big Medicine, and conservatives will have to accept the growth of strong public oversight.

The vast savings of Big Medicine could be widely shared—or reserved for a few. The clinicians who are trying to reinvent medicine aren’t doing it to make hedge-fund managers and bondholders richer; they want to see that everyone benefits from the savings their work generates—and that won’t be automatic.

Our new models come from industries that have learned to increase the capabilities and efficiency of the human beings who work for them. Yet the same industries have also tended to devalue those employees. The frontline worker, whether he is making cars, solar panels, or wasabi-crusted ahi tuna, now generates unprecedented value but receives little of the wealth he is creating. Can we avoid this as we revolutionize health care?

Those of us who work in the health-care chains will have to contend with new protocols and technology rollouts every six months, supervisors and project managers, and detailed metrics on our performance. Patients won’t just look for the best specialist anymore; they’ll look for the best system. Nurses and doctors will have to get used to delivering care in which our own convenience counts for less and the patients’ experience counts for more. We’ll also have to figure out how to reward people for taking the time and expense to teach the next generations of clinicians. All this will be an enormous upheaval, but it’s long overdue, and many people recognize that. When I asked Christina Monti, the"  command center "nurse, why she wanted to work in a remote facility tangling with staffers who mostly regarded her with indifference or hostility, she told me, 'Because I wanted to be part of the change.'

And we are seeing glimpses of this change. In my mother’s rehabilitation center, miles away from where her surgery was done, the physical therapists adhered to the exercise protocols that Dr. Wright’s knee factory had developed. He didn’t have a video command center, so he came out every other day to check on all the patients and make sure that the staff was following the program. My mother was sure she’d need a month in rehab, but she left in just a week, incurring a fraction of the costs she would have otherwise. She walked out the door using a cane. On her first day at home with me, she climbed two flights of stairs and walked around the block for exercise.

The critical question is how soon that sort of quality and cost control will be available to patients everywhere across the country. We’ve let health-care systems provide us with the equivalent of greasy-spoon fare at four-star prices, and the results have been ruinous. The Cheesecake Factory model represents our best prospect for change. Some will see danger in this. Many will see hope. And that’s probably the way it should be. "

Consistent, organized protocols and policies can streamline your practice and promote quality of care. See what Healthcare Business Management can do for you today at www.HealthcareBusinessManagement.com

Read the whole riveting amazing article by Atul Gawande it in The New Yorker!

Ode To Motherhood - Paying It Forward

Ode To Motherhood

Thinking back, it now begins to make sense; the blank stares; the lack of response; the way one of the kids would walk into the room while I was on the phone and ask to be taken to the store. Inside I was thinking, 'Can't you see I'm on the phone?' Obviously not; no one could see that I was on the phone, or cooking, or sweeping the floor, or even standing on my head in the corner, because no one saw me at all. I was invisible. Some days I was only a pair of hands, nothing more: Can you fix this? Can you tie this? Can you open this?? Some days I was not a pair of hands; I was not even a human being. I was a clock to ask, 'What time is it?' I was a remote control guide to answer, 'What number is the Disney Channel?' I was a car with an order to pickup, 'Right around 5:30, please.' Weren’t these the hands that once held books and the eyes that poured over history and music and art and the mind that graduated with honors - but now those hands had disappeared into the crustless peanut butter & jelly sandwiches they made, those eyes had disappeared while reading the same sentence in the “Are you my Mother?” book over & over again and that mind had disappeared while stirring oatmeal idly over the stove every morning - never to be seen again. There she goes! She's going, she's going, she's gone!

One night, a group of us were visiting with a friend of ours over dinner. We were celebrating her return from a fabulous trip, and she was going on and on about the hotel she stayed in. I was sitting there, looking around at the others all put together so well, drinking their martinis, taking in the room while making smart, fabulous remarks and it was hard not to compare and feel sorry for myself. I was starting to feel pretty pathetic, when our celebrated friend turned to me with a beautifully wrapped package, and said, 'Here, I brought you this.' It was a book on the great cathedrals of Europe. I wasn't exactly sure why she'd given it to me until I read her inscription: 'To Ruth-Ann, with admiration for the greatness of what you are building when no one sees.' In the days ahead I would read - no, devour - the book. And I would discover what would become for me, four life-changing truths, after which I could pattern my actions in this life:

1) No one can say who built the great cathedrals - we have no record of their names.
2) These nameless builders gave their whole lives for a work they would never see finished.
3) They made great sacrifices and expected no credit.
4) The passion of their building was fueled by their faith that the eyes of God saw everything.

A legendary story in the book told of a rich man who came to visit the cathedral while it was being built, and he saw a workman carving a tiny little bird on the inside of a beam. He was puzzled and asked the man, 'Why are you spending so much time carving that bird into a beam that will end up only to be covered by the roof, No one will ever see it'. And the workman replied, ’Because God sees.' I closed the book, feeling the missing piece fall into place. It was almost as if I heard God whispering to me, 'I see you, Ruth-Ann. I saw the sacrifices you made and the little things you still do every day, even when no one around you does. No act of kindness you've done, no salty tears you’ve kissed away, no cub scout patch you’ve sewed on or scarf you’ve rolled ‘just right’ or derby car you’ve helped carve, no cupcake you've baked, is too small for me to notice and smile over. You were helping to build a great cathedral, but even now you cannot see what it will become.'

At times, my invisibility felt like an affliction. But now I’ve come to realize that it is not a disease that has erased my life. In fact, it was and still is the cure for the disease of my own self-centeredness. It is the antidote to my strong, stubborn pride. I keep the right perspective when I see myself as a ‘great builder.’ As one of the people who show up at a job that they will never see finished, to work on something that their name will never be on. The writer of the book went so far as to say that no cathedrals could ever be built in our lifetime because there are so few people willing to sacrifice to that degree.

When I really think about it, I don't want my children to tell the friends they bring with them while visiting on holidays, 'My Mom gets up at 4 in the morning and bakes homemade pies, and then she hand bastes a turkey for three hours and presses all the linens for the table.' That would mean I'd built a shrine or a monument to myself. I just want them to want to come home…that’s all. And then, if there is anything more to say to their friends, to add…. 'You’re going to love it there.' As parents, we are building great cathedrals. We cannot be seen, if we're doing it RIGHT. And one day, it is very possible, that the world will marvel not only at what has been built, but at the beauty and strength and potential that was added to this world by the sacrifices of ‘The Invisible.’ Only after becoming a parent myself, do I realize how invisible we are to our children growing up and I think back now to the sacrifices you made Mom, all the clothes you sewed for your girls, and the thousand little things you did every day and I want to say, “I see you Mom. I love you Mom.” “Thank you.”

Ruth Rhinesmith - Ode To Motherhood




Self Awareness - You Can Choose

The ability to Lead....to Create....to Empower Others.....These are the charactersitics of a dynamic Manager.  Whether you are the Boss, a Supervisor, an Administrator, a Divisional Director, a CEO, a Partner, a Physician, or part of a Team, you are managing. Even if you have no employees you are still managing.....yourself. One of the fundmental characteristics of a Manager is to process everything through the paradigm of "Self Awareness."

Are you self aware?  Stephen Covey possesses a wealth of character-centered strategies based on this dynamic and much more. 

If you haven't already read it, The Seven Habits Of Highly Effective People should be at the top of your list.  It could very well turn everything around that you feel is wrong with your practice or your life.  We all have power.  The power to choose..

Choosing Success

Become self-aware....become powerful.

Yesterday does not hold today or tomorrow hostage.

Healthcare Business Management is centered around The Seven Habits.

Help yourself be all you would like to be. Envision what we could do for you.

www.HealthcareBusinessManagement.com

Personnel Problems?

Do not let your fire go out, spark by irreplaceable spark,

in the hopeless swamps of the approximate, the not-quite, the not-yet, the not-at-all.

Do not let the hero in your soul perish, in lonely frustration for the life you deserved,

but have never been able to reach.

Check your road and the nature of your battle. The world you desired can be won.

It exists, it is real, it is possible, it is yours!

Personnel problems? Don't know what to do?  Healthcare Business Management can help you with your HR problems so you don't have to be the BAD GUY. 

www.HealthcareBusinessManagement.com

SERVICES WE PROVIDE:

• Personnel Manual - Create and Update
  
• Safety Manual - Create and Update
  
• Personnel Task / Job Training
  
• Initial and Annual Training for: Incentives, Operations, Computer, Personnel, Compliancy, HIPAA, OSHA, Financial and Safety
  
• Payroll Account Setup - Service Interface and Report Hours
  
• Acquisition - Replacement - Hiring
  
• Hours, Vacation, Sick & Holiday Calculation
  
• FLSA Personnel Documentation & Standards Compliancy
  
• Benefit Package Development, Implementation, and Coordination as instructed for: Medical (including Psychological Recovery), Dental, and Life Insurance, Disability, Key Personnel, 401K or Defined Benefit Pension Plan, Vision, etc.
  
• Initial and Annual Compliancy Assessment
  
• Personnel Forms
  
• Setup of Human Resource Compliancy Task Calendar and Tickler File
  
• Customer Service Coaching and Training
  
• Ergonomic Assessment and Implementation for OSHA Standards Compliancy
  
• BiAnnual Reporting

HEALTHCARE OPERATIONS MANAGEMENT

"Many experts believe that Operations Management has become one of the most highly intense and challenging roles in the medical industry."

The goal of Healthcare Business Management (HBM) is to ensure smooth operation of various processes that contribute to the production of quality services by your medical practice. Our role could be varied and encompass many operational areas depending on your needs.

The following are examples of five most common areas of Operations Management under which Healthcare Business Management might contribute:

• Logistics Management
  
• Budget Management
  
• Operational Strategizing
  
• Support Services Management
  
• Third Party Relations Management
  
  Fulfillment of expectations that come from wearing multiple hats is the most challenging aspect of operations management. Many experts believe that operations management of the medical practice is probably one of the most challenging roles in the industry and it has now become greater within the context of HIPAA, Electronic medical records, Social Media Marketing and navigating the legal maze of confidentiality as it relates to the internet.
  
  With over 20 years of management experience, HBM can play a key role in chalking out the overall operational policy of your practice; and then provide your practice and personnel with a susinct and detailed operations policies and procedures manual to help you navigate compliancy and day-to-day business protocol.
  
  SPECIFICS
• Electronic Scheduling,Recordkeeping and Billing compliancy deadline by 2012-2015
  
• Document Management System Setup
  
• Backfill and Index Records (Scan, Database)
  
• Auto Update EMR via current system interface
  
• HIPAA Certification of EMR System
  
• Expired Paper Document Calendar Setup and Destruction / Shredding
  
• Inventory Management of Asset List, Office Consumables and Controlled Substances (see "Compliancy")
  
• Task/Project/Compliancy Calendar Creation
  
• Whole Office Tickler File System Setup and Use Training
  
• Compliancy File System Setup and Use Training
  
• Vendor, Contact, Business Associate Info List Setup and Merge To Attestation Signature Form
  
• Ongoing Update and Filing System Training and Upkeep
  
• Forms Creation and Implementation
  
• Workflow assessment
  
• Office Presentation and Seasonal Decoration
  
• Ergonomic Physical Facility Assessment & Recommendation
  
• Grandfathered Chart Archiving as necessary
  
• Develop Relationships and Contract with Third Party Entities PRN to Setup a New Practice

Are you a new graduate MD?  www.HealthcareBusinessManagement.com can help you navigate the mirade of regulatory and compliancy issues governing your new practice.  Call us at (949) 478-5821 to discuss what Healthcare Business Management can do for you!

Social Media Mistakes And How To Protect Yourself

 

Social media was once considered a realm for teenagers to tweet about what they had for lunch, but now it has become a ubiquitous platform in the healthcare field. With the increasing amount of physicians using social networks for professional reasons, in 2010, the American Medical Association (AMA) established guidelines to prevent physicians from online misconduct.

According to a survey published in the Journal of the American Medical Association, common violations have been: inappropriate communication with patients, cyber-prescribing medication without an established patient relationship and misrepresentation of credentials online.

Guidelines that help prevent this type of unethical behavior is certainly important, however with the massive amount of physicians (or so-called “physicians”) exercising their free speech in the vast network of blogs and social media sites, who is responsible for monitoring the healthcare community when their activity extends beyond the hospital walls and into the gargantuan World Wide Web?

As it stands, the responsibility lies in the hands of doctors themselves. As a physician, if you’re not policing your own online behavior, a fellow colleague may report any misconduct to the appropriate authorities and you could face serious consequences for your actions. Take heed and follow the four tips below to avoid the possibility of jeopardizing your medical career.

Keep your patient’s ailment to yourself.

As a common rule, do not discuss a patient’s condition online. Even if you do not disclose the patient’s personal information, you may unintentionally violate your doctor-patient confidentiality privilege. In a recent case, a Rhode Island emergency room physician had detailed her patient’s ailment on Facebook, and although she did not explicitly mention the patient’s name or demographics, the characteristics of the injury were specific enough so that a colleague was able to identify the individual. As of April 16, 2012, the physician’s clinical privileges at the hospital have been terminated. Let this incident serve as a lesson – respect your patient’s privacy and preserve the public’s trust in the medical community.

Keep all comments professional – even your personal posts.

A physician’s reputation is very important and it’s not worth undermining your career by publishing negative or inappropriate comments that you would never utter in the workplace. Even if your social media account or blog is limited to a group of friends and family, it’s risky to have the mentality of thinking that the public can never trace the content back to you. Social media privacy settings are fickle and with the ability to archive public information, the Internet rarely forgets. Even if you realize your mistake and remove the content afterward, there is no telling how many colleagues have already witnessed your inappropriate behavior or how much damage it has already caused to your reputation in the healthcare community.

Do not prescribe medication online.

Social media platforms are no doubt an excellent resource to find information about current health topics and to connect with colleagues in similar specialties, however, it is not a place to practice medicine. Among the most cited infracts reported by medical boards is internet prescribing without having established a face-to-face relationship with the patient. In rare cases, this violation has even led to the death of innocent consumers. Aside from already having a real-life relationship with your patient, other factors that separate misconduct from legitimate online prescriptions differ significantly from state to state. To see a breakdown of regulations by state, click here to read the National Clearinghouse on Internet Prescribing established by The Federation of the State Medical Boards (http://www.fsmb.org/ncip.html). In all cases, a physician should already have a good understanding of the patient's problem, medical history and current health status before issuing a prescription online.

Do not “friend” your patients on Facebook (or other social media venues).

While the AMA does not explicitly prohibit physicians from “friending” patients on social networks, it's safer to keep your profile private in order to maintain a professional doctor-patient relationship. Although family vacation photos and wild snapshots of you at your hospital’s holiday party may be harmless, they may not project the professional image you wish to maintain in front of your patients. By allowing your patients to read silly wall comments left by your friends and family, you may have trouble influencing them with your authority in medicine if their view of your professional ranking has diminished. It’s best to keep clear boundaries between your social and professional life. Don’t worry about offending your patients by declining their friend requests – simply follow-up with a cordial private message that explains your policy of not linking to any patients in order to maintain professionalism in your field. Your patients will appreciate and respect this type of honest and direct communication and they’ll likely feel less awkward during future visits. Nevertheless, while it’s best to play it safe by abiding to the above rule, if you really have the determination to reach out to your patients using a social media platform, be sure to create two separate accounts so that your personal information can remain totally separate from your professional profile.

As a physician, it’s important to remember that you don’t just represent yourself online, but you serve as an example for the medical profession as a whole. Don’t let your online behavior taint the status of your colleagues or hospital. Be respectful of these guidelines and reach out to fellow physicians who may need a little guidance in their own online behavior. Social media has the potential to be a valuable asset to healthcare professionals, but it’s up to you to make sure that this technology is encouraged and not abused.

Marketing for Your Medical Practice www.HealthcareBusinessManagement.com


A MGMA Report from Matthew O'Donnell