Dragon® NaturallySpeaking® Medical, from Nuance, is the leader in speech recognition software with over 80,000 clinician users in the U.S. and is directly integrated to Practice Partner Patient Records. Dragon NaturallySpeaking Medical and Practice Partner work together eliminating the need for a physician to navigate within screens of the EMR or chart a patient visit using a keyboard or tablet pen. Dragon NaturallySpeaking Medical allows physicians to dictate in their own words, generating documentation directly into Practice Partner EMR, which they can then edit and review. Dragon NaturallySpeaking Medical is 99% accurate and includes medical vocabularies covering nearly 80 medical specialties and subspecialties.

In addition, Practice Partner and Dragon NaturallySpeaking Medical have a unique integration that allows physicians to populate the entire chart from one single screen progress note. This feature frees the physician from having to update all pertinent areas of the chart because Practice Partner does it automatically. Furthermore, that data, such as all major problems and allergies, can then be quickly searched and reported on for quality measures, such as Pay-for-Performance. This unique relationship saves the physician time, enabling more time to be spent caring for patients.

Benefits of Practice Partner® EMR with Dragon® NaturallySpeaking Medical:
- Dictate faster and more accurately than ever before
- Dictate anywhere in Practice Partner
- Eliminate transcription costs
- Spend more time with patients
- Dictate in your own words
- Support higher reimbursement and reduce denials
- Improve clinician satisfaction

Learn more about Practice Partner EMR with Dragon here.

So the funding physicians have been hoping for over the past several years has finally been approved. Now the questions for lawmakers and funding administrators is how to get the process of EMR adoption moving forward.

Sen. Sheldon Whitehouse is attending this year’s HIMSS Conference and Exhibition in Chicago to address the Health IT funding’s purposes, as well as the challenges and next steps of gaining wide spread physician EMR adoption. He will be outlining his plans to address the following questions:

• How will we ensure the $19 billion is spent wisely and effectively?
• How will we ensure HIEs are ready to support electronic health records?
• How will we protect privacy? How will we build decision support in the new technology for doctors?

“Whitehouse would like to see the ARRA funds accomplish two major goals and he’ll introduce supporting legislation if necessary. He wants to make the adoption of EHRs less of a losing proposition for physicians than many of them believe the technology to be. And he’d like to fund a couple of geographic and/or specialty areas to focus on creating fully functional HIEs that demonstrate the value of communitywide interaction.

Before coming to the Senate, Whitehouse established the Rhode Island Quality Institute, a collaboration of stakeholders working to improve the quality of care. (”Sen. Whitehouse: Let’s Get to Work“)

Another session at the conference will also discuss ideas for physicians seeking to get their share of the stimulus funds. For more on the conference, click here. The need for EMRs is strong, however, according to a recent study published in the New England Journal of Medicine:

“Only 1.5% of U.S. hospitals have a “comprehensive electronic records system” implemented across all their major clinical units, according to a new survey of nearly 3,000 U.S. hospitals. Some 7.6% of hospitals have a “basic” system in place, the study concludes.

“The very low levels of adoption of electronic health records in U.S. hospitals suggest that policymakers face substantial obstacles to the achievement of health care goals that depend on health information technology,” the study concludes. “A policy strategy focused on financial support, interoperability and training of technical support staff may be necessary to spur adoption of electronic records systems in U.S. hospitals.”

The study also cites the most common barriers to electronic systems as inadequate capital (74%), concerns about maintenance costs (44%) and resistance among physicians (36%). Another recent report cited that 80% of physician practices nationwide still do not have an EMR. EMR providers such as Practice Partner and McKesson Healthcare are independently producing educational resources to support national and local efforts in the hopes that educating physicians on the new funding will help them understand how to move forward in the EMR software selection.

High Ridge Family Practice Improves Financial Performance with Integrated EHR Solution

High Ridge Family Practice, a busy, five-provider group of family practitioners in Stamford, Conn., has been committed to electronic health record (EHR) technology since 1990, when it implemented a rudimentary integrated EHR and practice management system. The practice finally hit the mark in 2004 with the right solution — an advanced integrated EHR, billing, scheduling, and ordering solution from McKesson.

Now, all charges are captured during the patient encounter with efficient electronic documentation. Billing is virtually seamless, and days in accounts receivables are low. With these efficiencies, the practice has grown, adding two physicians, increasing the number of patient visits per physician and improving overall clinical care.

At a Glance

Organization: High Ridge Family Practice, Stamford, Conn.
– Family practice
– 5 physicians
– Active patient population of 5,000 to 6,000
– 12,500 to 14,500 office visits per year Solution Spotlight
– Practice Partner® Appointment Scheduler
– Practice Partner® Medical Billing
– Practice Partner® Patient Records
– Practice Partner® Order Entry

Critical Issues
– Increasing productivity
– Improving profitability and cash flow

Results
– Annual gross charges increased by 30% after the first year
– Cash flow improved by 25%-30%
– Turnaround on insurance payments reduced from 45-60 days to 14-21 days

Read the full case study: “High Ridge Family Practice“.

Cookeville Primary Care Associates Combines EHR System and Research Network to Boost Care Quality

Cookeville Primary Care Associates, a two-provider family practice, sidestepped the challenges many small physician offices face in delivering the quality and efficient service payors demand through pay-for-performance initiatives. When it was established, the practice implemented Practice Partner® Patient Records, an EHR (electronic health record) system from McKesson, to access critical patient data usually isolated in paper files. It later registered with a clinical benchmarking and research network, Practice Partner® Research Network (PPRNet), to get exposure to best practices and specific quality of care reports for a variety of conditions.

By combining a world-class EHR system with PPRNet membership, Cookeville Primary Care gained a comprehensive quality-control tool that gives it the power to provide the evidence-based, preventive care payors now require.

At a Glance

Organization: Cookeville Primary Care Associates, Cookeville, Tenn.

– 2 physicians
– 4 staff members Solution Spotlight
– Practice Partner® Patient Records
– Practice Partner® Research Network Critical Issues
– Continuous quality improvement
– Participation in pay-for-performance programs

Results

– Ability to benchmark against other practices and measure improvement
– Improved patient care:
– The proportion of hyperlipidemia patients using anti-platelet therapy rose from 32% to 58%
– The percentage of coronary heart disease and stroke patients with their most recent LDL < 100mg rose from 57% to 71%
– The proportion of atherosclerotic patients with an LDL measurement in the past year rose from 56% to 75%
– The percentage of adult diabetic patients who had a pneumococcal immunization is 80% compared to the national average of 20%

Read the full case study: “Cookeville Primary Care Associates Combines EHR System and Research Network to Boost Care Quality.”

Many physicians have questions about the incentives for adopting an approved EMR under the new stimulus package, especially when it comes to Medicaid and Medicare incentives. According to a recent article, physicians will have to choose either Medicare or Medicaid incentives under the economic stimulus package because they cannot get both:

“Physicians who choose to participate in the Medicaid incentives “have to waive the right to a Medicare incentive,” explains Heidi Echols, partner at the Chicago law firm McDermott, Will & Emery. To qualify for extra Medicaid payments, hospitals and doctors must reach thresholds for percentages of patients who are eligible for Medicaid, she adds.

“Hospitals as well as physicians must have a records system up and running to begin earning Medicare incentives. In contrast, individual doctors can get as much as $25,000 in year-one Medicaid incentive payments to defray some of the cost of acquiring the technology, Echols says. Hospitals also can earn Medicaid reimbursement for technology acquisition costs in year one.

“Although the Act does not specify a start date for Medicaid incentives, “HIMSS believes it will be in 2011, based on Senate sources,” Echols says.

“After receiving the start-up Medicaid funding, physicians can earn up to $10,000 annually for four additional years to support “meaningful use” of electronic health records, the attorney adds.

“The six-year Medicaid incentive program for hospitals is more complex, she acknowledges. Hospitals must have a qualifying EHR in place by 2016 to receive any Medicaid incentive funding. And they must derive 10% of their patient volume from Medicaid to qualify for incentives.”

Read the full article: “Medicaid Incentives Explained“. According to presentation released by Practice Partner, beginning in 2011, physicians who are “meaningful users” of certified  EHR/EMRs are entitled to receive up to $44,000 of total incentive payments over five years:

• Year One Customer Qualification:        $15,000 ($18,000 if Year One is 2011 or 2012)
• Year Two Customer Qualification:        $12,000
• Year Three Customer Qualification:        $ 8,000
• Year Four Customer Qualification:        $  4,000
• Year Five Customer Qualification:        $  2,000
• You must qualify by 2013 in order to receive the full incentive ($39,000)
• For those who qualify in 2014, the maximum incentive will be $24,000
• No payments to any providers after 2016, or for those who qualify in 2015 or later

For physicians who do not adopt such technology by 2015, Medicare payments will be reduced by the following factors in the years specified:

• 2015:                    One percent
• 2016:                    Two percent
• 2017 and beyond:    Three percent
• 2018 and beyond:    Plus one additional percent/year (max of 5%) if 75% not automated

Advanzed Health Care Implements EHR System to Improve Patient Care and Boost Revenue

Advanzed Health Care, PLC, struck the perfect balance between enhancing revenue and improving patient outcomes when it implemented an electronic health record (EHR) system in 2001. Since then, the practice has increased the use of preventive care treatments for chronically ill patients, boosted productivity, and raised annual revenue by $40,000 per physician — all without the need for additional support staff.

At a Glance

Organization: Advanzed Health Care, PLC, Arlington, Va.

– Internal medicine practice
– 2 physicians
– 3.5 full-time employees
– Active patient population of 3,000, with 40% of patients on Medicare

Solution Spotlight

– McKesson’s Practice Partner® EMR

Critical Issues

– Improving the quality of patient care
– Increasing productivity

Results

– Increased average daily visits by 10%

– Increased annual revenue by $40,000 without additional staff

– Made measurable improvements in patient care:

– Coronary heart disease patients on a lipid-lowering prescription increased from 58% to 95%

– Hypertensive patients with a well-controlled blood pressure
increased from 45% to 84%

– Diabetes patients undergoing the microalbumin/creatinine test to evaluate kidney function increased from 4% to 85%

– Male patients more than 40 years old on antiplatelet medicatoon rose to more than 60%

Read the full case study: “Advanzed Health Care: Internal Medicine EMR Case Study“

The presentation, developed for Practice Partner customers, explains the recent HealthIT funding passed in the economic stimulus package and how the funds will be used to encourage nationwide physician adoption of EMRs. It breaks down the bill’s provisions, funding levels, incentives for early adopters, certification standards, and every key concept that physicians need to be aware with regards to this bill and moving forward in their EMR selection.

A new study released by Harvard Medical School suggests that patient involvement in the use of electronic health records can help improve the effectiveness of the technology. This suggests, the researchers point out, that all of the recent attention on EMRs due to the recent HITECH funding should not just focus on how doctors will use EHRs, the focus also should be on how EHRs can be used to get patients more involved in their care. As ihealthbeat.org reports:

“The study, conducted by Harvard Medical School and two other institutions, found that reminding patients to take a critical test is more effective than reminding their physicians about the same test. Researchers based their study on 300,000 EHRs used by the Harvard Vanguard Medical Associates, a group practice in Massachusetts that has had an EHR system for 12 years.

“The researchers identified 21,860 patients who were overdue for colorectal cancer screening and 110 physicians who treated those patients. The researchers then divided the patients and physicians into sample and control groups.

“The patients in the sample group received personalized letters informing them they were overdue for colorectal cancer screening and offering them information about testing. In addition, physicians received pop-up reminders that patients were overdue for colorectal cancer screening when they accessed EHRs during office visits.

“After 15 months, the study found that about 44% of patients who received a reminder went for a screening, compared with 38% of patients who did not receive a reminder. However, the electronic reminders for physicians did not lead to a significant increase in screening rates, BusinessWeek reports. “

Read the full article: “Patient Involvement Key to Effectiveness of EHRs, Study Says“. Still, a lot of the industry focus is still on bridging the gap of physician adoption, especially as patient volume is down in many practices and a recent report showed 2008 as an abysmal year for hospital profitability.

Despite these trends, most vocal healthcare leaders remain supportive and optimistic of the new funding package. The executives of the National eHealth Collaborative (NeHC), Healthcare Information Technology Standards Panel (HITSP) and Certification Commission on Healthcare Information Technology (CCHIT) - John Tooker, MD, John D. Halamka, MD, and Mark Leavitt, MD - state that the widespread use of healthcare information technology is a critical first step to curing much of what ails the healthcare system, the heads of three national healthcare organizations say in a “Shared Roadmap and Vision for Health IT,” released last month. (See article here)

Other reports cite the need for IT standards, uniform security standards and other regulations as keys for the success of the HealthIT funding initiative. Doubtless many of these issues will be addressed by the newly appointed healthcare reform team. More news to come!

Below is a link to CCHIT’s 2nd annual Physician’s Guide which gives in depth information on the certification process, what it means to be a CCHIT certified EHR and benefits of purchasing today. Practice Partner Patient Records EMR is one of only a few ambulatory electronic health record systems to have met CCHIT certification requirements every year since the inception of CCHIT in 2006. Most recently, Practice Partner Patient Records Version 9.3 became a CCHIT Certified® product for CCHIT Ambulatory EHR 2008 and Child Health. Download the guide here: “CCHIT’s Physician’s Guide to Certifications to 08 EMRs“.

The Healthcare Information and Management Systems Society Conference, the HIMSS09 Healthcare IT Conference and Exhibition, will include 10 education sessions focused on the impact of the health IT provisions in the American Recovery & Reinvestment Act of 2009. This is part of the HIMSS Economic Stimulus Education Program to educate physicians on the types of funding and benefits outlined in the stumulus, the effects and potential benefits of the funding, and more topics, including:

• The Goal of Economic Stimulus: A Democrat / Republican Panel
• Funding in Economic Stimulus: The Scope of the Opportunity
• A Strategic Approach to Managing Opportunities and Risks for Health IT in Economic Stimulus
• Optimizing the Opportunities in Economic Stimulus for Rural and Community Health
• Optimizing the Opportunities in Economic Stimulus for the Physician Practice
• Economic Stimulus For Healthcare Enterprises: Bracing for Funding
• Achieving Health Information Interoperability by Leveraging Economic Stimulus
• The Effect of Economic Stimulus on State HIT Projects
• ONC’s Plans for Its Economic Stimulus Funding
• Developing a Plan to Operationalize the Results of Economic Stimulus

For more information on the conference or these sessions, click here.