There is a newly formed Center for Healthcare Transparency (CHT) that is part of Centers for Medicare & Medicaid Services (CMS).

This new center aims to strengthen quality and cost information when it comes to healthcare. The program has ambitious goals, including, wanting half of the U.S. population to have access to reliable cost and quality information by 2020. Many healthcare leaders have been looking for something like this, because now is the time for changes that can improve efficiency. Without a doubt, the healthcare system is going through a transformation. According to the chief data officer for CMS now is the time for this new program and the new changes. He states, "A few years ago, you could've put everyone interested in transparency in a closet, and there would've been room left over." 

Recently, CMS took a major step in the direction of transparency in healthcare processes. It released data on Medicare Part D that indicated that the program spent $103 billion on prescriptions in 2013. The AMA criticized this, stating, "troubled by the lack of context provided with that could help explain physician prescribing practices and pharmacy filling practices before conclusions are drawn." So, there are clearly some issues with transparency, and in particular price transparency; this issue of price transparency is gaining some importance due to the rise in medical options and increase in consumerist healthcare trends. It is clear that this industry is changing at a rapid rate. Anytime there is change, in any situation, transparency can help aid any new challenges and can provide good insight into just how effective the changes have been. The CHT will be a good step in the right direction.

CHT can help tackle the issue of accountability in this ever-changing healthcare industry, and this is vital now especially, because of new technologies and new ways of practicing medicine that are different than they have been historically. Value-based payment models are a hot topic related to this, and there will be more information and more programs rising out of these new models. David Lansky, CEO of Pacific Business Group on Health, summed up the importance of transparency, saying, "if we're going to pay everybody based on value, we better be measuring it in a sensible way." 

What does this mean for medical scribes and EMR? Having a medical scribe in the picture helps track patient data more effectively and accurately. This goes to together with transparency, because accuracy and transparency are linked. It seems that more transparency is inevitable, and scribes already contribute to transparency, because of their documentation expertise. EMR use has been shown in many instances to increase productivity and efficiency by keep more accurate records of patients medical visits and history. 

Information gathered from FierceHealthcare article, "Center for Healthcare Transparency aims to strengthen qualilty, cost information" 

A few years ago, one of the first big whitepapers on EMR as a hot growth area for staffing came out, titled "The Electronic Paper Trail: Why EMR is Staffing's Hot Growth Area", and this piece identified the EMR growth in healthcare. But, with this "hot growth area" that is EMR staffing for implementation comes another piece to the puzzle, one that our team at Scribe Solutions is very familiar with: the medical scribe. The article says, "healthcare information technology is the new big thing in staffing, thanks to the growing need for healthcare organizations to implement electronic medical record (EMR) systems. While this article is correct in saying that there is/was a growing need for healthcare organizations to implement EMR systems, since this article was written in 2011 some of that has changed and the new need is for data entry. There was an initial wave of EMR systems implementations following the Affordable Care Act becoming effective in 2010.

While some organizations still have a need for EMR systems implementation, there is a new need tied to Health IT, as mentioned above, and that need is for data entry into these EMR systems. Patient records need to be properly documented online, especially with meaningful use requirements in place, and often times this documentation  adds extra hours of work to doctors' already busy work schedules. Here is where scribes come in: scribes take away this burden, and as the meaningful use deadline approaches, hiring scribes is more important than ever for these busy physicians. 

More literature has come out on the need for scribes, and the benefits of hiring scribes are becoming more evident. The American Academy of Orthopaedic Surgeons boldly highlights these benefits in its published paper on the benefits of using scribes. On the top of the AAOS paper it is clearly stated in the header:Physicians can spend more time with patients; charting accuracy is increased. 

The AAOS paper's author, a physician himself, makes a strong case for hiring scribes, and who better to hear this news from than a practitioner himself. G. Klaud Miller, MD, the author of the paper, is a member of the AAOS Practice Management Committee who is in private practice in Chicago. Miller highlights the reasons why scribes are key to success in the age of required documentation using EMR, advocating:"...using a scribe saves time. The physician never has to do after-hours dictation in the office or bring charts home to dictate. The chart is completed when the physician leaves the examination room. A physician who sees 20 patients a day and spends 5 minutes per chart dictating or writing the notes saves more than an hour and a half of time by using a scribe. Independent of any of the other benefits, how much would you pay to get an extra hour and a half or more per day?"

He says it best when it comes to summing up just how helpful hiring scribes is and how using scribes is the way of the future, stating, "Although using a scribe may sound like a luxury to some, I have found that scribes more than pay for themselves in numerous ways, and I would never practice without one."

Workflow and organization management are important concepts to healthcare as a whole, but specifically these concepts are key to hospital management. Not only can flaws in workflow hinder the activities of hospitals, but also it can cost a great deal of money to correct flaws. 

A recent survey by the Ponemon Institute of 400 plus healthcare providers discovered that poor communication on its own has an estimated economic impact of $1.75 million per U.S. hospital. Also, the survey found that this inadequate communication alone has an estimated annual economic impact of more than $11 billion industry-wide.  

It is clear that many of these costly issues are complex in nature, but some quick fixes can be implemented to decrease inefficiencies. 

• In addressing lack of effective communication methods: the use of secure text messaging could increase productivity and minimize economic loss by about 50 %
• Looking at duplicate documentation requirements: eliminating inefficiency here can allow for more patient time and higher quality patient care and management can fix this by surveying the system to find duplicates and then can address EHR issues with the vendor; next the duplicates can be reconciled with the EHR provider
• Dealing with patient flow: address processes and review occupancy and manage ORs and facilities by providing a process for scheduling date and time of patient discharge at least one day in advance
• Ensure appropriate hospital admission: provide practitioners with resources, for example options such as social workers, nursing homes, behavioral health centers, skilled nursing centers and rehab services to eliminate inappropriate hospital stays
• Avoid incomplete medication reconciliation: try to obtain adequate information from patient, but also use EHR effectively to ensure accuracy 

As electronic medical records take their place in modern medicine, new questions arise as to the use of EMR, medical education and technology, and the use of electronic documentation as a tool for teaching. 

Now, first year medical students are tech-savvy and able to be on top of the times when it comes to health IT. EMR is starting to be included as part of medical curriculum.  This new addition to many medical education programs adds value. EMR is relevant to medical education because electronic documentation is becoming a necessity, especially with new meaningful use requirements and the shift to ICD-10. 

EMR education can be beneficial to not only medical students, but also to nurse practitioners, physician assistants, and physicians. The electronic medical record can be useful in guiding through the process of assessing the patient. The EMR helps give insight into the background of the patient and can help lead to the key facts and information to reach a potential diagnosis. EHR use can help in listing red flags, risk factors, and warnings about potentials risks for the patient in reaching a diagnosis. For example, EMRs can warn about patient drug allergies or interactions and assist in addressing patient treatment programs. This can help providers to limit their liability. For medical students and healthcare professionals learning the new technology and where technology intersects with patient care, EMR teaching can be truly beneficial. 

Information gathered via LinkedIn post:Using the Electronic Medical Record as a Teaching Tool

Is your practice or organization ready for ICD-10? 

It is clear that ICD-10 needs to be taken seriously. Experts are weighing in, and they are noting that ICD-10 should not be underestimated. For example, Health IT policy director for the Medical Group Management Association, Robert Tennant, wrote on ICD10monitor.com that, "Any organization that looks at the past delays for the coding system and doesn't take the upcoming compliance date seriously is putting their revenue at risk." 

So, since it is vital that your organization take ICD-10 seriously, what can you do to ensure readiness? 

Here are some ways to prepare for the implementation of ICD-10:

• Have an impact chart - conduct an impact assessment and obtain information discovered by this; assessment will show the area impacted and what changes to organization processes will need to happen, and will bring to light impact on coding and billing and vendor management 
• Complete Documentation - Make certain that patient documentation is accurate and up-to-date; ensure accurate codes, and most accurate information has been included in patient records. This will facilitate changes tied to ICD-10 and will help make certain no payments are delayed or denied
• Test - Testing and practice can ensure preparedness; providers can practice billing and coding in old systems but can make sure the information is right to assign the most specific ICD-10 codes

Practices need to maintain systems and continue to improve on implementing technological changes. EMR use can be beneficial, but if not used properly or in the most efficient manners, EMR can be a hassle to organizations. It is important to be prepared and to stay updated on CMS news and continue proper billing and coding and patient record documentation. EMRs benefit practices and organizations by maintaining an electronic paper trail of patient visits and medical conditions and history. Using EMRs can be overwhelming and now with ICD-10 it is clear that physicians and their staff are swamped with work. Hiring a medical scribe could be helpful to your organization. If interested in hiring a medical scribe to help with the proper documentation of patient records please feel free to submit an inquiry on scribesolutions.com. 

Information gathered from FierceHealthIT feature on ICD-10 readiness

Interoperability has become a key topic in today's healthcare research and this issue has brought the collaboration between the private and public sector into the spotlight. 

The Office of the National Coordinator for Health IT has increased efforts recently, timing these efforts with the Meaningful Use deadlines approaching organizations nationwide. U.S. Department of Health and Human Services Secretary Sylvia Matthews Burwell announced a new program last week that would be a two-year grant program for $28 million to encourage adoption of health IT and to increase interoperability, thus supporting the use of the health information exchange. HHS and the new program will include 12 new awards; these awards will be cooperative agreements to states, territories or state designated entities to continue work under the same intent as the original State Health Information Exchange Program. 

As quoted in FierceHealthIT, HHS Secretary Burwell spoke about the new program: "This two-year grant program will ask awardees to demonstrate innovative, community-based solutions to advance, standardize, and secure an interoperable movement of health information across organizations, vendors, and geographic boundaries."

She continued to discuss the importance of the new program for interoperability: "It's important to remember the real reason we're doing this work because if we succeed in our efforts around interoperabilty and delivery system reform, it means that a patient who's admitted to a hospital or referred to a specialist will be more likely to get the right tests and medications because her doctors are doing a better job of coordinating with each other." 

As we know in the medical scribe industry, the increasing presence of technology in healthcare operations can increase efficiency. While technology can improve efficiency and help streamline activity in practices and hospitals, this high-tech environment can cause headaches in the process. This HHS program and the Health Information Exchange are keys to improving the quality of care for patients. But, it is key to hire the right people to implement these changes and to help in the adoption of the rapid changes in the way the healthcare industry does business. Medical scribes can be of assistance to busy practices and organizations that are adapting to the new technological changes in healthcare. 

Centers for Medicare and Medicaid Services recently announced that it is considering proposals to shorten the meaningful-use reporting period to 90 days in 2015. Providers have been requesting this change.

What does this mean? 

This change would mean that providers could meet the meaningful-use requirements and in turn could avoid financial penalties with software in place for less time than what is currently required.

It is clear the providers are faced with the modernization of healthcare and improving efficiency in healthcare today. Many have turned to EMR and medical scribes to adapt to meaningful use as a whole, but extensions in the reporting period among other changes could help physicians transition smoothy and without hassles and headaches. 

Experts and researchers have weighed in on this potential change.

President and CEO of The College of Healthcare Information Management Executives, an organization that is an advocate for the changes in reporting period length, stated, "Meaningful use has the potential to be a transformative program for the nation's healthcare delivery system and we commend CMS for recognizing the need for a course-correction." Other groups have also praised CMS for looking into/and most likely changing the reporting window. The Medical Group Management Association and The American Medical Association praised the CMS for agreeing to modify the window, and they are pushing for CMS to issue the new rule quickly. 

In addition, according to the Modern Healthcare article, CMS also is considering changing reporting periods to the calendar year to "allow eligible hospitals more time to incorporate 2014 Edition software into their workflows...and will modify other aspects of the program that may lessen providers' reporting burdens.

Also, CMS explained that the rulemaking on reporting period flexibilty will be separate from the upcoming third-stage meaningful-use rule, which is expected to come out in March. 

Meaningful use takes some navigating by these physician groups. While CMS is doing its best to work with practices and hospitals to come out with the best-fit programs for healthcare as a whole, this space can be tough to handle in a busy healthcare environment. Medical scribes can lead to increased efficiency, and this has been proven in many practices and organizations. Scribes may be the answer to some of the problems physicians are facing in the switch to EMR. With supportive legislation from CMS and useful and beneficial programs by CMS, together with scribes, healthcare as a whole is on the path to becoming a more organized, high-tech sector. 

According to a new study by global consulting firm Accenture, consumers with chronic illnesses are less bothered by privacy concerns tied to EMR. Instead, the chronically ill are more concerned about the privacy of shopping and banking transactions than EMR and healthcare records. 

The study's research shows that more than half (51 percent) of the U.S. chronically ill (consumers who have chronic conditions) feel that the benefits of accessing medical records electronically outweigh any risks of privacy invasion. In this study, titled the Accenture 2014 Patient Engagement Survey, more than 2,000 U.S. consumers were polled. A unique fact was uncovered in the study, that when it comes to perceived risks in terms of privacy and EMR, the opinions on the matter varied based on specific chronic illnesses of each type of patient in the survey. 

The highest percentage of patients believing that EMR benefits outweigh the risks were those with cancer (57 percent). Other patients that were surveyed had smaller percentages of belief on the risks versus benefits of EMR; asthma and arthritis patients weighed in at a 48 percent belief that benefits of electronic health record sharing outweigh perceived risks. Another key finding in this study is that patients expressed their desire for access to EMRs, revealing their belief in the right to access their EMR, with 69 percent saying that having access to their health data is a human right. 

Additionally, Accenture's findings indicate that it is clear that people, especially those with chronic conditions, want access to their health records. But, as fedeal legislation supports the shift to EMR, it will be interesting to discover just how many patients will shift to accessing their records via EMR technology. While the switch to EMR may seem daunting to many practitioners and patients alike, medical scribes can ease the transition to EMR. Meaningful Use Stage 2 is here, so this topic is pertinent. Scribes can help improve efficiency in healthcare practices and organizations. Combining new technology with the added resource of a scribe can increase efficiency and aid in the better documentation of patient health records. 

ICD-10 has been in the news...alot. Whether you like it or not, ICD-10 is going to be shaking things up. So, it is better to get on board now, before it is complicated and costly to do so at a later date.

The American Medical Association published a list of the top 10 issues for physicians to watch in 2015, and ICD-10 implementation and meaningful use are part of this list. 

The AMA list examines the large amount of regulatory requirements, and this list explains that these regulatory requirements can take away from what is most important to most physicians...treating the patient. According to the AMA research, in order to advance health IT, many are asking for some relief when it comes to government mandates. While improving efficiency can be a result of switching to electronic medical records (EMR), the heachaches and hassles that many physicians are facing relate to government regulation and lack of time in effectively treating the patient while also switching to EMR. On the AMA list, meaningful use is focused on and the need for improvement is highlighted, according to FierceHealthcareIT.  

Meaningful Use has been criticized as being too broad and its one-size-fits-all nature has been called incomplete. Sustainability of practices is of great concern to physicians today, so these issues and complaints noted in the AMA list need to be addressed in order to allow for the efficency that improved documentation can provide. Medical scribes can assist in the shift to electronic medical records (EMR) and can stay on as continued providers of efficient documentation of patient records. Using a medical scribe can take away the obstacles that many physicians face in treating the patient while also using EMR technology. Healthcare efficiency is an important topic in today's world, and while the technology can be helpful in documenting patient records and staying organized, using the technology can be time consuming without the assistance of scribes. 

According to the article, the AMA has pushed for end-to-end ICD-10 testing, which the Centers for Medicare & Medicaid Services announced would take place from Jan. 26-30, April 26-May 1, and July 20-24. Also, the article notes that many are starting to make the shift to ICD-10, citing figures by CMS, which revealed that acceptance rates during the November ICD-10 acknowledgement testing week improved to 87 percent.