Nursing Home Management Systems

New realities managing are placing pressures on the healthcare industry, and how patient care is delivered. Rising hospital/nursing homes management costs, an aging population, a shortage of healthcare workers, challenges in accessing services, timely availability of information, issues of safety and quality and rising consumerism are some of the facts of today’s healthcare system. The industry has reached a point of chasm, where they need to decide how services could be delivered more effectively to reduce costs, improve quality, and extend reach.

The 18,000 nursing homes in the United States provide a broad variety of skilled nursing services, with dedicated missions of quality, compassionate care and healthy, happy lifestyles. They also must manage the business of nursing homes-keeping beds full for healthy census, competing better, nursing home admissions and referrals, marketing long-term care services effectively, innovating with nursing home management software systems and other technologies, operating more efficiently and productively and increasing revenue and profitability. An EHR is the answer to this which automates the operations of nursing homes and long term care facilities. Managers use Long Term Care applications to improve the efficiency and accuracy of their administrative functions. This kind of software offers a variety of flexible features which assist in the management and organization of patient records, billing and invoicing and staff and appointment scheduling. Long Term Care software is related to Electronic Medical Record software, Healthcare Management software and Medical Billing software.

These management systems (EMR/HER) are powerful, flexible, easy to use and are designed and developed to deliver real conceivable benefits and more importantly they are backed by reliable and dependable support (Provided you choose wisely). You will require less number of Staff to cater more patients in same time or even less and would have the choice to re-deploy them at other suitable locations by using an EHR, which not only provides an opportunity to enhance the patient care but also can increase the profitability of the organization.

Nursing Homes can better serve the rapidly growing number of health care consumers in a cost-effective manner with the use of a suitable EHR by enabling administrators to significantly improve the operational control and thus streamline operations. This would also improve the response time to the demands of patient care because it automates the process of collecting, collating and retrieving patient information. The software interface would also save them a lot of time for special jobs only. The reduced cost of the manpower would pay eventually for the cost of management system within a short time after its implementation.

The most important benefit for both the nursing home and home health staff is anytime and anywhere access to health information afforded by an EHR. This access to electronic records is sharply contrasted to locating and retrieving the single copy of the resident’s paper chart, which may be in use by another individual, requiring not only the time to find and retrieve the record but also delays in waiting for the record to become available. In HHAs, the time savings and care coordination benefits are clearly substantial with various clinicians at multiple locations needing to review or make an entry into the record. A major benefit, accessing health records from remote locations, which enables remote providers such as physicians to review charts, make clinical decisions, authorize orders, and perform other tasks in a timely manner without traveling to the facility/agency.

Second benefit would be greater efficiency in meeting administrative and federal requirements in long-term care. With complexities related to determining eligibility for coverage, case mix reimbursement, and the numerous federal, state, and insurance carrier requirements in long-term care, administrative systems that are integrated with clinical information in EHRs yielded substantial benefits to providers. Bills are automatically generated from clinical information entered into the EHR leading to shorter billing cycles. Information used for payment is going to be more accurate with automated edit checks. Administrative staff could be more efficient and accurate, as they do not need to enter information that could be automatically pulled from the EHR. Claims denials and resubmissions are reduced. Most providers reported reductions in administrative staffing because of accrued time savings.

A third benefit that is universal, although not fully realized, is improved quality management through reports, alerts, and decision-support tools. Electronic reports to routinely track status, alerts that identifies specific residents/clients with a more immediate concern, dashboards that require an action before logging out and automated risk tracking are the basis for numerous examples of early intervention to prevent problems like falls, weight decline, skin breakdown, and hospitalization. The availability of quality information requires an informed user to review reports on a systematic and regular basis, which is often difficult for nursing homes and HHAs to achieve.

Data exchange with physicians for order review and approval minimized duplicate data entry and data exchange with hospitals facilitated patient admission and transfer processes. To fully benefit from HIT in long-term care, interoperable systems that allow for HIE are an essential step to achieving care coordination and effective transitions across settings.

Final Rule For Meaningful Use Of EMR

The Department of Health and Human Services (HHS) released the final meaningful use rules on Tuesday, July 13th, 2010, at 10:00 AM. These rules outline the features Electronic Health Record (EHR) software must provide in order to become certified. Purchasing software with the required features is not enough; physicians will have to use the features according to defined measures in order to qualify for the stimulus funds.

HHS Secretary Kathleen Sebelius said, “For years, health policy leaders on both sides of the aisle have urged adoption of electronic health records throughout our health care system to improve quality of care and ultimately lower costs. Today, with the leadership of the President and the Congress, we are making that goal a reality.”

Bill Connelly, an attorney with the Healthcare Division of the New York-based law firm of Manatt, Phelps & Phillips LLP, said the changes made by the CMS in quality measures were significant. The CMS dropped the measures from 90 to 44, and physicians only need report electronically on three. For example, if a patient has diabetes, a physician or hospital is required to report that they are in fact taking blood pressure readings on that patient, or if a patient has had a heart attack, they must report that they have prescribed an aspirin regimen. Part of the reason for the dropping so many of the requirements in the first phase of meaningful use rules is that CMS itself has no way to receive reports electronically much of the time, Connelly said.

The new rules were finalized after a three-month public comment period during which more than 2,000 recommendations were received by the U.S. Department of Health and Human Services on its preliminary “notice of proposed rule making” effort. The final document is 864 pages long.

So, if you are a physician and you’ve been holding back, the time to act is now.  And if you have any doubts on why this is so important to your practice, your patients and America consider this:

While 46 percent of U.S. primary care doctors report using Electronic Medical Records – up from 28 percent in 2006 – they lag well behind:

• Netherlands (99%)
• New Zealand (97%)
• U.K. (96%)
• Australia (95%)
• Italy (94%)
• Norway (97%)
• Sweden (94%)

US Healthcare is big i.e. $2.5 Trillion.  The government has a huge stake.

U.S. Health Insurance Coverage: 2009 data published in 2010

• Uninsured: 46.430 million
• Medicare 46.589 million
• Medicaid 46.867 million
• Medicare/Medicaid -3.382 million
• Other 4.841 million
• Public: 94.914 million
• Group 169.342 million
• Individual 26.777 million
• Private: 196.119 million

Mark Segal, vice president of Government and Industry Affairs for GE Healthcare IT, said CMS basically took what were a set of “all or nothing” rules and accounted for the realities of implementing EMRs in a short time frame. For one, they lowered the percentage of EMRs that had to include patient demographic and vital sign information from 80% to 50%. “It’s more attainable. It gives them more leeway,” he said.

One thing the CMS had no flexibility with in its rules was the 2015 deadline for implementing EMRs. The timetable for meeting the standards was set in stone by the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009. In HITECH, healthcare entities must implement EMRs by 2015 or face monetary penalties in the form of Medicare reimbursement funds.

“I think there’s a lot of folks that are all of a sudden realizing that they’re in a real predicament. What I sense from talking to other organizations is that they didn’t take this quite as serious as they should have,” said Bill Fawns, director of IT services for County of Kern Medical Center in Bakersfield, Calif.

“Our approach to meaningful use has been to throw it back to our vendor. So contractually we obligated our vendor to deliver meaningful use however the requirements turn out,” Fawns said.

He said one of the greatest challenges with deploying an EMR has been setting up a wireless infrastructure in a hospital campus that has a mixture of new and old buildings, and pushback from the hospital staff.

“We’re a teaching hospital, so on one end of the spectrum we have residents born with a computer in their hand and so they look at this as an opportunity to move forward; on the other side of the spectrum are the physicians who are in their 60s and the very idea of signing onto a computer is a big question mark to them,” Fawns said.

While he sympathizes with organizations struggling with implementing EMRs, Fawns said he has mixed feelings about organizations that would complain about the 2015 deadline the government has set.

“We’re aggressively going after this. Part of me thinks other organizations could have done that too,” he said. “My guess is there will be enough cries that deadline will be extended. But even it it’s left as it is now, it is enough time if they want to get serious about an EMR.”

Segal said the 2015 deadline is not as dire as it appears. While HHS wanted all entities to achieve stage three meaningful use by 2015, that spurred concerns among healthcare providers who voice their concerns, and were heard.

“In some cases, if you started EMRs later, you needed to move through each stage in one year. That didn’t logically take into account the time needed to progress from one stage to another,” Segal said.

The final rules state that reimbursement payments for Medicare providers may begin no sooner than October for eligible hospitals, and no sooner than January 2011 for eligible health care professionals. The rules allow providers to begin EMR implementation in 2012, 2013 or 2014, and still have two full years to implement stage one standards. Health care providers only need to record 90 days of EMR information to report to CMS to qualify for reimbursement payment, instead of a full year as the preliminary rules required.

EMR Usability

The Healthcare Information and Management Systems Society (HIMSS) report, “Defining and Testing EMR Usability: Principles and Proposed Methods of EMR Usability Evaluation and Rating,” (June 2009) provided important insight into the need to consider usability as a primary driver behind the acceptance, implementation and success of Electronic Medical Records (EMR) systems in the United States. The HIMSS report does an excellent job describing core usability principles and suggests that these principles could be the foundation for the development of an EMR usability rating method. The report contends that such a rating system would help identify useful and important distinctions between competing EMR systems.

As can be gathered from the title, the report focuses on the usability of electronic medical records (EMRs).  More specifically, as noted in the scope of the report:

“We discuss the usability of the EMR from the perspective of clinician users (physicians, nurses, pharmacists, physical therapists, respiratory therapists and others) in the ambulatory, inpatient and acute‐care environments. We confined ourselves to issues of user‐centered design and usability evaluation. These concepts apply to vendor product development processes, public product usability rating methods and vendor selection criteria for healthcare organizations. In addition, these methods should be applied in the configuration of highly adaptable systems during implementation. We do not otherwise address concerns of implementation, user training or change‐management, though these issues do affect user adoption success rates” (p. 4).

The report identifies nine usability principles that are relevant to EMRs, including:

• Simplicity
• Naturalness
• Consistency
• Minimizing cognitive load
• Efficient interaction
• Forgiveness and feedback
• Effective use of language
• Effective information presentation
• Preservation of context

The report also discusses different usability evaluation methods (e.g., contextual inquiry, task analysis, expert review, risk assessment, etc.) and metrics (e.g., efficiency, effectiveness, ease of learning, etc.), selecting tasks for evaluation (e.g., find LDL, count CAD risk factors, drug-interaction alert & response, etc.), usability rating systems, and EMR certification.

The report closes with six recommendations that certifying organizations should consider when developing a usability rating program, including:

• Start small
• Develop measurements
• Create a 5-star rating system
• Define the process
• Improve with time
• Encourage others to do their part

With this definition of design in mind, it becomes clear that the current HIMSS usability focus on the evaluation of EMR systems

Final Rule For Temporary Certification Program For EHR Issued By ONC

The Office of the National Coordinator for Health Information Technology (ONC) today issued a final rule to establish a temporary certification program for electronic health record (EHR) technology. The temporary certification program establishes processes that organizations will need to follow in order to be authorized by the National Coordinator to test and certify EHR technology.

Use of “certified EHR technology” is a core requirement for providers who seek to qualify to receive incentive payments under the Medicare and Medicaid Electronic Health Record Incentive Programs provisions authorized in the Health Information Technology for Economic and Clinical Health (HITECH) Act. HITECH was enacted as part of the American Recovery and Reinvestment Act (ARRA) of 2009. The Centers for Medicare & Medicaid Services will soon issue final regulations to implement the EHR incentive programs.

Certification is used to provide assurance and confidence that a product or service will work as expected and will include the capabilities for which it was purchased. EHR technology certification does just that: It assures health care providers that the EHR technology they adopt has been tested and includes the required capabilities they need in order to use the technology in a meaningful way to improve the quality of care provided to their patients.

On March 10, 2010, the U.S. Department of Health and Human Services (HHS) issued a notice of proposed rulemaking (NPRM) entitled Proposed Establishment of Certification Programs for Health Information Technology. The NPRM proposed the establishment of two certification programs for purposes of testing and certifying EHRs — one temporary and one permanent. The temporary certification program final rule issued today will become effective upon publication in the Federal Register. The final rule for the permanent certification program is expected to be published this fall.

“By purchasing certified EHR technology, hospitals and eligible professionals and hospitals will be able to make EHR purchasing decisions knowing that the technology will allow them to become meaningful users of electronic health records, qualify for the payment incentives, and begin to use EHRs in a way that will improve quality and efficiency in our health care system,” said David Blumenthal, M.D., M.P.P., national coordinator for health information technology. “We hope that all HIT stakeholders view this rule as the federal government’s commitment to reduce uncertainty in the health IT marketplace and advance the successful implementation of EHR incentive programs.”

About the Temporary Certification Program and ONC-ATCBs
To provide assurance to eligible professionals, eligible hospitals and critical access hospitals (CAHs) that the EHR technology they adopt will assist their achievement of meaningful use, the Department of Health and Human Services (HHS) issued a final rule to establish a temporary certification program for EHR technology on June 18, 2010. The rule outlines how organizations can become ONC-Authorized Testing and Certification Bodies (ONC-ATCBs). Authorized by the National Coordinator, ONC-ATCB are required to test and certify that certain types of her technology (Complete EHRs and EHR Modules) are compliant with the standards, implementation specifications, and certification criteria adopted by the HHS Secretary and meet the definition of “certified EHR technology”.

About the Standards, Implementation Specifications, and Certification Criteria
On January 13, 2010, the Secretary published in the Federal Register an interim final rule that adopted standards, implementation specifications, and certification criteria for HIT. A final rule, which will realign with the Medicare and Medicaid EHR Incentive Programs final rule, is expected to be released in the near future.

What Certification Means for Health Care Providers
EHR technology, certified by an ONC-ATCB must be used in order to qualify for incentive payments. The temporary certification program provides assurance that the EHR technology health care providers adopt is technically capable of supporting their efforts to achieve meaningful use.

What Certification Means for Developers of EHR Technology
The temporary certification program provides a way for developers of EHR technology to have their HIT tested and certified so that it can be subsequently adopted by eligible professionals, eligible hospitals and CAHs who seek to achieve meaningful use.

This final rule is issued under the authority provided to the National Coordinator for Health Information Technology in section 3001(c)(5) of the Public Health Service Act (PHSA) as added by the HITECH Act.

Healthcare and iPad

There’s been an ongoing buzz about the potential impact of the iPad in the healthcare sector. The omnipresence of iPad in healthcare industry, at this point, is not certain although it promises great opportunities in the future of tablet computing platform’s usage in healthcare industry.

The iPad’s enhanced user interface, native support for eReading, immaculate GUI, ability to use numerous medical calculators (a heap of them already present in AppStore) and several other medical apps can be an incredibly rich learning experience for physicians.

All the above mentioned qualities points out towards a possibly best patient-clinician interaction in healthcare, of course it means a better patient education platform. Introduction of iPad in healthcare seems to present itself with countless ways to capitalize, a physician will have complete access to his patient’s records on the tip of their fingers, ability to review a given treatment to any patient, say a surgical procedure, prior to the operation showing rich anatomical details (e.g., a patient’s 64 slice color enhanced 3D CAT scan), potential risks, etc. this is revolutionary! One can also use the video feed for external help or educational purposes.

With a lot of potential in your hand with a simple touch based interface, imagine going into an examination room where your iPad is able to determine which patient you are dealing with and conjuring the appropriate records for you and can now present you with a purpose-driven interface for that particular patient encounter. How many times have you been in a patient encounter only to wind up wasting time navigating through your files trying to find the right information? What if you had an app that organized it all and through context awareness, presented what you needed? With iPad it might be possible to do so in a jiffy.

The initial memory of iPad is 16 Gigabytes but that should be enough to cater a physician’s need regarding patient’s records. You can collect videos about a patient’s condition and treatment then show them while you point out things with the stylus. A 16 Gigabyte capacity means there is plenty of room for a patient’s current chart, including all their imaging tests. You can keep track of your whole day’s work in the palm of your hand even use it to remotely load charts from nursing station as soon as a patient is admitted.

Available for cheap prices (comparing it with Apple’s other merchandise of course) this is almost certainly the future of healthcare and use of EMR. Quite simply, this device transforms medical practice and delivers a solid, easy-to-follow upgrade path directly from paper.

It’s not that the iPad is going to change the scenario completely. But it should prove to be an accelerator of trends that are already happening and are inevitable. It’s cheap, it’s easy to use, it’s got all the power and connectivity you want, and it looks pretty cool too. In short, It’s the right device at the right time!

Lab Data Exchange & EMR

A considerably large amount of information used by physicians for medical decision-making is produced in the lab. Consequently, a major portion of the clinical data populating EMRs comes from the lab. It is therefore inevitable for lab managers today to effectively integrate data from one information system to another via EMR within the rest of the health organization or network. With clinical results being such a key component of the EMR, the laboratory information system (LIS) is the critical link in the flow of data throughout the healthcare continuum.

Electronic transmission of lab test results is an important part of clinical data. On March 1, the Centers for Medicare and Medicaid Services (CMS) together with the ONC released new guidance, clarifying that the Clinical Laboratory Improvement Amendments (CLIA) -federal law that regulates standards and quality assurance of all clinical laboratories, whether commercial labs, hospital labs, or doctors’ in-house labs- has permitted the electronic exchange of lab data. Although considered a mature sector, labs of all types and sizes continue to evolve their communication and integration strategies both internally and via critical outreach to physician practices and healthcare organizations. While IT innovation closes the remaining direct communication gaps between lab devices and the LIS, the growing challenge today and on the horizon is integration between the LIS and the EMR. In an evolving lab/client world where each situation is different, the approaches to LIS client outreach vary from situation to situation as well.

With more physician practices making the move from paper-based records systems to electronic systems, physicians expect to be able to easily access all patient information, including clinical and pathology test results, in a central location with a global means of communication from one system to another. One of the items in the ONC guidance is the encouragement of labs to use a particular standard method and vocabulary when exchanging lab data (HL7 2.5.1 as the transport standard, with LOINC as the test-identification vocabulary).

Regardless of the way of managing reports by an EMR system and its ability to report information directly to patients, either by secure email or by a Personal Health Record (PHR), the CLIA rules and the guidance from the ONC has helped pave the way for these tasks. Soon availability of accurate and meaningful health information for patients and physicians will be securely available on a wide scale.

DEA Allows E-Prescription Of Controlled Substances

An interim rule issued by DEA (Drug Enforcement Administration) would allow E-Prescriptions of controlled substances. The interim rule was published in the March 31 issue of the Federal Register. The final rule will go into effect following a 60-day comment period. The Office of Management and Budget, which has been following the DEA’s rule making, has signed off on the e-prescribing rule. Computer-generated prescriptions from physicians to pharmacies for drugs such as oxycodone (OxyContin, Purdue), methylphenidate (Ritalin, Novartis), diazepam (Valium, Roche), and hydrocodone bitartrate/acetaminophen (e.g., Abbott’s Vicodin or Forest’s Lorcet and Lortab), are illegal until the DEA finalizes this rule.

The highlights of the rule:

• give prescribers the option of e-prescribing controlled substances;
• permit pharmacies to receive, dispense and archive electronic prescriptions;
• reduce paperwork for DEA registrants, such as family physicians;
• help pharmacies and hospitals integrate prescription records into other medical records;
• increase efficiencies and reduce the wait time for patients having prescriptions filled; and
• potentially reduce prescription forgeries.

The rule is available for inspection now and will be officially published as a Notice of Proposed Rule Making (NPRM) on March 31. As with other NPRMs, there will be a 60-day open public comment period before it goes into effect, with potential modification depending on commentary received.

Authentication is a major issue here and only DEA-registered providers can electronically prescribe controlled substances which would require e-prescribing systems to be able to validate the identity of the prescriber and the prescription’s legitimacy. Special watermarked paper (which clinicians needed to purchase from authorized vendors) were used for prescribing such medication before and required a manual signature but now an alternate way of validation must be introduced.
Validation of prescribers should be a two step approach:
1) Someone other than the prescriber must authenticate the prescriber.
2) The other one can be biometric authentication.

The DEA is uncertain about the extent to which existing biometric readers will be used in healthcare settings but believes it is reasonable to allow for such technology because the technology is likely to improve. The rule itself does not require the use of a specific form of biometric technology. However DEA is establishing standards for biometric systems in conjunction with the National Institute of Standards and Technology (NIST) for this purpose.

The change however is pleasant news indeed for the healthcare industry regardless of the final shape of DEA’s rule. The inability to e-prescribe any controlled substance has been a limiting factor for the promotion of the adoption of e-prescribing and of EHR systems. The need of introducing modern technologies in healthcare industry is growing day by day and being able to use modern technologies in this important area of clinical practice is absolutely welcome.

Why Implement EMR Now?

The million dollar question right now is ‘Why should we implement EMR/EHR now?’ most of the physicians ask themselves if they should wait until 2010 or 2011 to implement EMR/EHR? If you answered No to this then congratulations, because you just won the Medicare or Medicaid Stimulus Bonus Payments.

The key financial benefits and reasons for not delaying and taking immediate action for implementation of EMR/EHR includes:

Physician EMR Stimulus Incentive: From $44,000 to $64,000 in Medicare or Medicaid bonus payments for adopting EMR/EHR. Penalties are set for those physicians/hospitals who do not demonstrate meaningful use of EMR by 2015. So the sooner you start, the maximum you gain.

Electronic Prescribing: A successful E-Prescriber will receive bonus payment of 2% on allowable Medicare Part B charges. An individual eligible professional must report one E-Prescribing measure in at least 50% of the cases in which the measure is reportable by the eligible professional via EMR. Penalties will be unveiled in 2012 if your Practice is not using E-Prescribing

EMR Software Tax Deductions: The economic stimulus package boasts of an extra 50% bonus tax deduction in 2009. For example, if the purchase amount is $300,000, the first $250,000 can be written-off in year 1, leaving the difference of $50,000 to be depreciated over several years. However, in 2009 an additional bonus amount equal to 50% of that difference (or $25,000) can also be written-off (for a total deduction of $275,000). This is a significant and tangible value for all medical practices that update, replace, or add any software and or capital equipment in 2009.

Increasing Revenues: The investment in EMR/EHR software will pay for itself as the administration expenses will lower significantly and on the other hands revenues are deemed to increase as well.

So all this debate points out to one and one thing only, you should start planning about implementing EMR/EHR as soon as possible that is if you want to take advantage of the EMR/EHR incentives and are not eager to face the penalties. You are best advised to get started NOW.

EMR Stimulus Incentive

After the signing of American Recovery and Reinvestment Act (ARRA) by President Barack Obama physician practices have a question in mind, ‘howdoes this affect me?’

The stimulus package announced for the year 2009 promised $19 billion for the medical industry to help implement technology that makes healthcare safer and more connected. One’s who proves to be meaningful users of EMR/EHR can receive an incentive reimbursement of up to $64,000 over a period of 6 years. Hospitals can qualify for $2-8 million in funding. It must be kept in mind that 70% of the incentive is received within the first 2 years. So you need to start early in order to receive the maximum reimbursement.

The US Dept of Health and Human Services (HHS) outlined these criteria for Meaningful Use of EMR:

•  Improve quality, safety, efficiency, and reduce health disparities
  
•  Engage patients and families
  
•  Improve care coordination
  
•  Improve population and public health
  
•  Ensure adequate privacy and security protections for personal
  

2011 qualification criteria include the following:

• 90 day reporting period to prove meaningful use through required measures
  
• At least one clinical decision support rule relevant to a specialty or a high clinical priority
  
• Electronic claim submission to payers
  
• Electronically check insurance eligibility (when possible)
  
• Provide patients with timely electronic access to their health information;
  
• Provide patients, upon request, with an electronic copy of their discharge instructions and procedures at the time of discharge; and
  
• Require the capability to exchange health information where possible in 2011, with participation in a national health information exchange by 2015
  

*By 2013, it is also expected that criteria will extend to include the ability to provide patients with access to their personal health records populated in real time.

Physicians qualifying under the Medicaid provision can receive up to $63,750 over a period of 6 years and they can receive their incentive payments starting from January of 2011. Payment is calculated as 85% of the EHR cost (up to $25,000 for the first year), and 85% of annual cost (up to $10,000) over the following five years. If you are to qualify for the Medicaid provision, at least 30% of your cases must be attributable to Medicaid. The minimum percentage of Medicaid patients is reduced to 20% for pediatricians. However, office-based pediatricians are only eligible to receive up to two thirds of the maximum payment.

Physicians qualifying under the Medicare provision can receive up to $44,000 over a period of 5 years and they can receive their incentive payments starting from January of 2011. The total amount that you receive is based on how early you adopt and your Medicare Part B billings. (You must submit Medicare Part B claims to qualify.) You will receive the lesser amount of either 75% of your Medicare Part B charges or $44,000 over a five year period from 2011 to 2015.

The total amount that you receive is based on how early you adopt and your Medicare Part B billings. (You must submit Medicare Part B claims to qualify.) You will receive the lesser amount of either 75% of your Medicare Part B charges or $44,000 over a five year period from 2011 to 2015. You can also qualify for an early adopter incentive of $3,000 (if you qualify for either 2011 or 2012.) MAXIMUM incentives (including $3,000 bonus) will be paid as follows:

• $18,000 for the 1st year
  
• $12,000 for the 2nd year
  
• $8,000 for the 3rd year
  
• $4,000 for the 4th year
  
• $2,000 for the 5th year
  

Physicians who do not implement EHR technology by 2015 will suffer from a 1% reduction in Medicare Payments (reductions will continue to increase after 2015 up to 5%). if they fail to implement the EMR/EHR technology by 2015.

Remember, to receive your maximum payment, you must start NOW!

E-Prescribing

E-Prescribing or Electronic-Prescribing is the process where a prescription is generated automatically when a prescription for medication is entered into an automated data entry system (handheld, PC etc) thereby generating an electronic prescription instead of a hand written one.

E-Prescribing isn’t just a way to send prescriptions electronically to pharmacies but also it can ensure an increased care quality in different ways, discussed later in this article. E-Prescribing holds a considerable importance in Healthcare IT, which is precisely why Medicare devised payment incentives for physicians using a qualified e-prescribing system. In 2009 the incentives, when E-Prescribing was used, were an increase of 2% in revenue for each patient. Due to the 2009 HITECH Act, electronic prescribing is required as part of any EMR (EHR) which qualifies for Medicare reimbursement in 2011.

E-Prescribing is a better means of communication between the patient, physician, and pharmacist. Mixing drugs resulting in adverse drug effects, a frequent cause of hospitalization, can be controlled when complete medical records for each patient will be available to both the doctor and the druggist, which is of utmost importance to avoid drug conflicts. Since some drugs conflict with others causing reactions and even poisoning. The idea behind this is simply to safeguard the patient from being prescribed any medication which may result in unwanted outcome.

Using E-Prescribing technology, every patient will have a complete and comprehensive medical history in their E File. The doctor can then easily decide on the best possible medication to use and can contact the pharmacy directly instead of writing prescription manually. There is almost no chance of error this way as the prescription will be automatically cross referenced with the patient’s records to ensure there is no conflicting prescription from another doctor and will be sent automatically via internet to the pharmacy. So when the patient will arrive at the drug store, the medicine will be waiting already.

• E-prescribing makes sure that the physician provides enough information for the pharmacist to fill the prescription, including the name of the drug, the dosage and the physician’s instructions.
  
• E-Prescribing eliminates the time and effort to interpret the physician’s handwriting, as well as the chance of an error in it’s translation.
  
• E-prescribing is often used in conjunction with clinical decision support to ensure that any drug to drug interactions or drug to diagnosis issues are found and reported to the physician before the prescription order is completed.
  
• It reduces the number of errors caused by illegible prescriptions.
  
  
• It is quite convenient. Some systems even give the drug choices on
  screen, so sending a prescription is just a tap or click away.
  
  
• It’s safe. As discussed above it prevents most adverse drug events by warning the physician based on the patient’s medical history
  and use of other medications.
  

It also eliminates transcription errors from phoned-in prescriptions and minimizes the risk of accidental filling of sound-alike medications. E-Prescribing is cost effective and ensures there is no malpractice. It saves time as it uses internet instead of relying on the old fashioned method of filling prescriptions after reading the doctor’s handwriting then verifying and making the patient wait for the needed medications. E-prescribing is a secure alternative to paper prescriptions, which can be stolen, copied or in some cases even forged.