October 1, 2015 is a big date. Things will change. Be prepared!

AthenaHealth recently hosted a webinar on transitioning to ICD-10. According to AthenaHealth, "the new code set, ICD-10, increases the number of reporting codes from about 13,600 to more than 69,000"; so as you can see, there are some complexities to changing from ICD-9 to ICD-10. 

As you can see in the increase in number of reporting codes, there will be an increase in reporting detail with ICD-10. This transition from ICD-9 to ICD-10 could be very costly for your organization, but there are some preventative measures you can take as a precautionary step.

As a precaution, you and your organization need to converse with your vendor and keep up with the vendor as you transition to ICD-10.

In order to avoid unnecessary costs and headaches, you should ask your vendor some important questions. Here are some helpful questions you should ask your vendor to allow for a smoother transition to ICD-10:

1. What is covered by contracts?
2. What are plans and timelines?
3. How will systems work with both ICD-9 and ICD-10?
4. What does implementation process entail?
5. What are costs, if any, for training and support in shift to ICD-10?

Info gathered at AthenaHealth webinar. For more info on AthenaHealth visit their website http://www.athenahealth.com/

Patient engagement is a hot topic today. But, while patient engagement is still important, it might not be the only hot topic when it comes to the term "engagement". 

Employee engagement is another "engagement" that today's businesspeople need to give some attention. The health and lifestyle of employees need to be key to management if staff. With today's everchanging health landscape and the risks of epidemic and antimicrobial resistance on the rise, prevention is vital when it comes to employee health. 

According to a Fierce Healthcare special report, leaders in the health care space can achieve goals of engaging employees for wellness by laying out employee wellness programs.

This is very important in the healthcare industry, because a recent study shows that healthcare professionals are no healthier than their patients.

As you all know, EHR is present in modern health care, and it is here to stay.

That being said, it is not being welcomed by all, and many are criticizing EHR. Some doctors are less than thrilled with EHR capability and ease of use. But, while there is criticism, like with any new tool introduced into an industry, EHR is useful and changing modern health care for the better. Yes, EHR can be overwhelming and too much to handle at times for the physicians, but that is why medical scribes exist. Hiring scribes can help.

One doctor in particular discussed his thoughts on EHR in a recent article, and his comments were interesting and important, because they help us understand the physician perspective.

Dr. Danny Newman discussed EHR with Georgia Health News. He realizes that electronic health records are here to stay, and he has seen firsthand some of the benefits of replacing paper charts with electronic ones. He said that one advantage of EHR is electronic prescribing of medications, which he says reduces mix-ups caused by illegible or messy handwriting.

But, as mentioned above, we all know that physicians are still not thrilled with EHR, despite seeing some of the benefits associated with going electronic.

Newman highlights his frustration, saying, “They’re (EHR) supposed to be more efficient...but I think they’re less efficient”. According to the article, for Newman a patient visit now produces five pages of notes, instead of a single page in the pre-EHR days, and it takes about five minutes to fill in the EHR for one visit. Newman is pretty clear in his frustration with EHR, when he says, “It’s taking away time from my patients".

As Newman says, nowadays “Many doctors feel like they’re data entry clerks”.

But they don’t have to be, and there is a helpful solution: scribes.

ACOs have been mentioned recently, so it is important to understand just exactly what ACOs are...and CMS lays it out for us.

ACO stands for Accountable Care Organization. According to the CMS website, here is the definition of ACOs: Accountable Care Organizations (ACOs) are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients.

Coordinated care is meant to make sure that patients, particularly the chronically ill, get the right care at the right time, while avoiding duplication of services and preventing medical errors.

When an ACO both delivers high-quality care and spends health care dollars more efficiently, it will share in the savings it achieves for the Medicare program.

For more info, see the CMS link where this information was gathered: ACOs link 

Use of electronic medical record systems is associated with considerable loss of free time per clinic day, according to a research letter published online Sept. 8 in JAMA Internal Medicine.

This does not make EMR look like a good data managment method to adopt.

But, EMRs are the way of the future, and can be very beneficial...with the help of a medical scribe. 

Doctors should treat patients; they shouldn't be typing all day and trying to use new technology. 

Clement J. McDonald, M.D., from the National Institutes of Health in Bethesda, Md., and colleagues surveyed the American College of Physicians' national sample of internists to examine the extent of EMR-associated time loss. Data were obtained from 411 respondents (mainly attending physicians).

"The loss of free time that our respondents reported was large and pervasive and could decrease access or increase costs of care," the authors write.

Technology can drive physician success

Gone (well, almost) are the days of paper charting and missing patient files and unorganized patient management. Technology has changed the patient management landscape - for good.

Physicians are benefitting greatly from technology - they use cloud technology, electronic health records, and automation. These physicians are becoming leaders in accountable care organizations (ACOs) and in ICD-10 adoption, meaningful use implementation, and provider patient connectivity.

In the recent issue of Healthcare IT News, the way technology is driving physicians success is discussed:

“As more clinics across the country adopt EHRs, they are finding that the technology dovetails nicely with other systems, enabling data management for population health, establishment of patient portals, medication tracking and electronic prescribing among other things.”

(Zack Wilson of CSI Healthcare IT quoted in Healthcare IT News)

Doctors are paying attention to the technological changes and the way these changes are benefiting physicians across the country.

Jen Polello, a principal consultant with Arcadia Healthcare solutions says that these doctors are starting to pay attention to EHR and are adapting to EHR out of necessity:

“(Technology adoption) is mainly borne by necessity rather than pure desire...they realize it makes sense from a clinical and business standpoint.”

Meaningful Use was created in order to create infrastructure for the health information system in American medical industry today.

The various stages were thought out and decided upon in order to ensure successful EHR use to establish an electronic health information network in the United States.

• Stage 1 - this stage was established for data capture and sharing to start taking place

• Stage 2 - this stage, began in January 2014, and intends to advance processes

• Stage 3 - this stage leads to improved outcomes

Requirements for Providers:

When looking at requirements for providers, these must be broken down into Medicare program requirements and Medicaid program requirements.

• Medicare program meaningful use requirements include 13 core measures that must be met and 5 of 9 optional measures. A 90 day reporting period to execute against goals of the program is also required.

• Medicaid program requirements include showing proof that the practice has purchased and installed a government certified EHR and after 1 year the practice must then meet the medicare requirements also with the 13 core measures.

Meaningful Use and its requirements intend to allow for progress tracking and more connectivity.

While using EHR will improve connectivity and is the way of the future, it is a lot of work for practices and physicians. But, it doesn't have to be! Scribes can help.

• Our medical scribes here at Scribe Solutions perform all the data entry work but also can assist in other services such as tracking labs, transcribing radiology reports, attending to patient needs, and helping physicians organize data.

• Scribe Solutions understands the demands that physicians face and offers a low cost, innovative approach to significantly improve the process of patient care.

As most of you probably know, Meaningful Use is rooted in the HITECH act. If you don't already know or understand the HITECH act, here is a "snippet" from Health and Human Services website:

The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, was signed into law on February 17, 2009, to promote the adoption and meaningful use of health information technology.  Subtitle D of the HITECH Act addresses the privacy and security concerns associated with the electronic transmission of health information, in part, through several provisions that strengthen the civil and criminal enforcement of the HIPAA rules.  

HITECH act allows for financial incentives for EHR use. The goals behind these incentives include the desire by the U.S. Government to have an efficient and centralized National Health Information Network and better quality care for patients. 

To qualify for government's financial incentives, the practices need to demonstrate meaningful use and purchase and use of a government certified EHR system. Physicians must meet all meaningful use requirements to qualify for incentives from the government. 

See more info here at CMS.gov 

You may be surprised to learn that the majority of U.S. medical records are not available electronically. Despite this alarming fact, the U.S. medical industry is increasingly switching to EHR. According to the American Journal of Managed Care (AJMC), in 2008, fewer than 10% of hospitals utilized a basic EHR system.

But, by 2009, doctors and hospitals were starting to adapt and began to switch to EMR due to funding from the stimulus from Medicare and Medicaid payments. 

The EMR switch is sweeping the U.S. medical space, with 60% of hospitals having adopted at least a basic EHR system today, according to AJMC. 

Health IT is becoming more important each and every day. As doctors and hospitals become more and more accountable to the quality of the care they provide to patients, high-tech, high-performing electronic medical records will be key to successful treatment and management of patients.  

EMR On Rise, But Still Obstacles to Overcome in Overall Health IT

While EHR use is clearly on the rise, there are still some general challenges related to Health IT. The rise in EHR use is clear, with around 26 percent of hospitals having a comprehensive EHR system - and this number is quintuple that of the figure from 2010, according to an AHA report. So, yes, EHR is being used more, but most hospitals are using basic EHR systems.

With this, it brings up the question of when and how will hospitals start using more advanced systems, but in an efficient and reasonable way. The AHA has conducted studies on this issue, and has found that 59 percent of hospitals have a basic or comprehensive EHR system (quadruple the figure from 2010) but while the majority of these hospitals meet most of Stage 2 meaningful  use requirements, only 5.8 percent are able to meet all of the standards.

According to eWeek’s article, “Stage 2 Meaningful Use includes 16 core objectives, such as the ability to view and download their health information, as well as the ability of hospitals to transmit health information between facilities, such as a skilled nursing center and a hospital.”

While critical access hospitals (CAHs) appear to be behind, hopefully they can bridge the gap and adapt to Stage 2 Meaningful Use.

Stay tuned for updates on Stage 2 Meaningful Use and how to overcome obstacles related to Health IT and EHR.