EMRs: Your transition from paper

Going to electronic records is more than flipping a switch. Practices must determine what do with old charts -- and how long to hang onto them.

During the change to an electronic medical record system, the focus for many practices is on how data will be collected, stored and analyzed going forward. But in most cases, there are many years' worth of historical data in paper files that physicians will need post-EMR.

Many practices are left wondering what data should be transferred to the EMR and how. And what happens to the data that remain on paper?

Jonathan Bertman, MD, a family physician in Hope Valley, R.I., who founded the EMR company Amazing Charts, said it's unrealistic to think that going live with an EMR and going paperless will happen simultaneously. "They are two separate things," he said. And people need to get used to the EMR before they feel comfortable walking in to see a patient without the crutch of a paper file, he said.

But the more information from paper that can go into the EMR, the better the experience physicians will have, said John Trudel, MD, assistant medical director of informatics at Reliant Medical Group, formerly Fallon Clinic, a large multispecialty medical group practice in central Massachusetts. However, it's unnecessary -- and in many cases cost-prohibitive -- to transfer every last piece of data when the chances of a physician needing it are low.

Though there are many ways practices have handled the transition, it comes down to three major decisions: what data get transferred, when and how the transfer occurs and how long the paper files continue to be used in the exam room. Experts say those decisions are based on a cost-vs.-benefit calculation.

What gets transferred?

What data are transferred into the EMR format is a question Dr. Bertman is asked by many clients. The answer, he said, "depends on how anal-retentive you are."

Kaveh Safavi, MD, North America health lead for the management consulting firm Accenture, said the data that are considered critical will depend on each practice and physician.

"From the doctor's perspective, the main issue is: Do you have the information you need to care for the patient at that point of care? And most doctors will say you don't need to see everything that happened in the past," Dr. Safavi said.

"If I am an oncology practice and these are patients that I am monitoring and have been treated over months, and lab values matter and chest x-rays matter, you have a totally different theory about how much information you need to see a patient. And if I am a primary care doctor, it might vary based on the age of my patients and the type of patients I see. There is no monolithic answer."

It's relatively simple when it comes to a solo practice. The physician decides what's important and what he or she can live without. But for practices with several doctors, and especially those with multiple specialties, experts say decisions about data should be based on a consensus that is reached by all physicians or specialties involved. And some concessions probably will have to be made.

"There's a significant cost to having people physically go into a medical record, look through the medical record and say, 'What do we bring forward to the new record?' because they had to actually physically go in there and type it in, so it's a labor-intensive process and very costly," Dr. Trudel said. His clinic was recognized for its use of health information technology as a 2011 recipient of the Healthcare Information and Management Systems Society Davies Award.

Robert M. Turner, DO, a family medicine specialist and co-managing physician of clinical information technology at the Kelsey-Seybold Clinic, a large multispecialty clinic system in Houston, said that before his organization's EMR system went live, the clinic decided to enter the data for the 100 most-seen patients of each physician. Of those patients, the extracted data were what they considered crucial, such as allergy, medication and problem lists, medical and surgical histories and immunization records.

From a medical-legal standpoint, the paper chart remains the official medical record of that patient for the time before the EMR implementation. Dr. Turner said. "So we only wanted to put things in the electronic medical record which we need to make decisions going forward about the patients." He said the EMR did not need to become a repository for nonessential information, since the paper charts still would exist, but the group didn't want physicians to start with an empty chart.

The when and how

A major expense associated with the transition to electronic records is the transfer of data. Whether a practice invests in bridge technology to smooth the transition, hires transcriptionists to manually enter the data, or brings on people to scan paper documents, data transfer probably is going to be a significant line item in the EMR budget. How the data transfer occurs will determine how much it costs, as each option varies in price.

There are different types of bridge technologies that can help with the transfer of data. Some are as simple as scanning technologies that capture the data and create files that are attached to the EMR; these can be queried using keywords or character recognition. Other, more complex technologies can scan the data and enter it into the EMR's data fields.

Sean Morris, director of sales for Digitech Systems, a bridge technology vendor, said most of the practices that use his products scan everything. There's no need to keep the paper files if everything is scanned, although most practices retain them for a year or two, he said.

Many practices either use their records staff or hire temporary help to scan old paper files. Dr. Bertman recommends scanning only important data in the beginning and manually adding other information to the EMR as each patient is seen.

The Kelsey-Seybold Clinic decided to use its physicians to do the initial scanning work.

Kelly Bruce Lobley, MD, pediatrician and co-managing physician of clinical information technology for Kelsey-Seybold Clinic, said having the doctors enter the data ensured the integrity of the information and helped them learn the new system.

For patients outside of the 100 seen the most frequently, their essential records were scanned into the system when they made an appointment. After each visit, the physician told the records staff if additional information needed to be extracted from the paper files and entered into the EMR.

Phasing out Paper

Most experts agree that it is not a good idea to phase out the paper immediately upon EMR implementation. Unless every piece of data contained on paper is going to be scanned, the paper records will have to be retained for some time. How long depends on each state's record-retention laws. But the time it takes for paper to be phased out of each clinical visit usually depends on the physician.

Michael D. White, MD, assistant professor of medicine at the Cardiac Center of Creighton University in Omaha, Neb., said that a year into the EMR implementation, paper charts still are used routinely during patient visits. The practice decided to make the charts available for the first two visits of each patient, after EMR implementation.

"Folks are much more comfortable having paper available so they can make sure the diagnosis and the problem lists were the same in both locations," Dr. White said. Once they see that the information is there, they believe things won't be so bad, he said.

The Kelsey-Seybold Clinic also made the paper charts available to physicians for as long as they needed them after implementation. Dr. Lobley referred to the paper charts as "training wheels" that made the physicians feel more secure. Most physicians phased out the paper charts after a year but can still request them. They can scan the paper charts for additional information that may need to be added to the EMR.

Reliant Medical Group also made paper records available for each patient visit for six months after implementation, and physicians still can receive paper charts upon request for review. Chris Diguette, director of application services for Reliant Medical Group, said physicians use the charts to check for discrepancies and validate that the data were transferred correctly.

Although the old records need to be retained for some time in some fashion, most of what is in them is probably not important, Dr. Bertman said. But trying to get rid of them all at once will not make for a smooth transition.

"The going-paperless thing is exciting and eventually is the key for most practices," he said. "Most of our long-standing practices are paperless, but to try and do that on day one or even in the first month or two is just asking for more headaches than it's worth."

This article was originally posted at http://ping.fm/ZtEp8

Integrated ontologies in the search for scientific understanding

From chemicals to minds: Integrated ontologies in the search for scientific understanding

View more presentations from Janna Hastings

Presented at the 2012 Interdisciplinary Ontology (InterOntology) Conference in Tokyo, February 24th 2012. This presentation gives a whirlwind tour of some "reports from the front lines" of practical bio-ontology development in ChEBI and in the Mental Functioning and Emotion Ontology projects. 

 

Medical Transcription India is Served by Experts

Medical Transcription simply means re-presentation of dictated words into etched form, the dictation by the physicians and healthcare experts regarding patient valuation, progress, medical actions, clinical progression, diagnosis, prognosis, in order to file patient care and provide various healthcare services. Simply putting, medical transcripting is typing out a recorded voice message of a doctor. A medical transcriptionist is a medical language specialist who, using a computer, headphones and a foot pedal, transcribes the recorded audio into automated data. This data is further examined for parsing and accuracy by a proofreader. The common practice followed by doctors is to dictate and record information and reports of the patient, either into audiotape, Dictaphone or on to digital voice processing systems. These tapes are then sent to external medical transcription companies involved in medical transcription to convert these voice dictations into hard text reports. These reports represent the patient's treatment history, including impost and are called Medical transcripts.

A transcriptionist requires the skill of literateness. Because there is the opportunity for just about any word in a given language to be used during the course of a meeting or session that will require transcription, the listener must have the ability to transliterate what is heard precisely. This includes understanding idioms that may be employed by various speakers, being able to use punctuation in such a way that the enunciation of the speakers are captured as much as possible, and being able to record the dialogue exactly as it occurred. To understand and accurately record dictated reports, Medical Transcriptionists must understand medical terminology, anatomy and physiology, diagnostic procedures, pharmacology, and treatment assessments. They also must be able to translate medical terminology and abbreviations into their expanded forms. To help identify terms appropriately, transcribers refer to standard medical reference materials-both printed and electronic; some of these are available over the Internet.

Medical transcription services can be performed by MTs who are working in hospitals or who work at home as telecommuting employees for the hospital; by MTs working as telecommuting employees or independent freelancers for an outsourced service that performs the work offsite under contract to a hospital, clinic, physician group or other healthcare provider; or by MTs working directly for the providers of medical transcription services, either onsite or telecommuting as employees or contractors. Hospital facilities often prefer electronic storage of medical records due to the sheer volume of hospital in house patients and the accumulation of tons of paperwork. The electronic storage in hospitals database gives immediate access to concerned departments and even medical transcription services providers regarding the patient's care to date, amount of previous or present medications, notification of allergies, and establishes a history on the patient to facilitate healthcare delivery regardless of geographical distance or location. This has to be done quickly and efficiently.

Medical transcription India is served by highly qualified team of experts to provide incomparable medical transcription services. Medical transcription companies consist of a team of transcriptionist, copyreaders, quality regulators and proofreaders, who have great proficiency in utilizing the software tools and dictation apparatus. The experts of medical transcription field transcribe complex medical records and reports into 100% error free documents. Professionals serving in the industry need to have good listening and language skills of several medical descriptive. Person interested in this field need to undergo full-fledged training in order to meet the demand of this service sector.

This article was originally posted Here

Amplify EHR Efficiencies with Medical Transcription Services

With the widespread adoption of electronic health records (EHR) in the last few years, physicians have generally been presented with two options: modernize, or get left behind with old-fashioned paper medical records. However, with the implementation of EHRs, some physicians feel typing in a computer is not only inefficient, but also unfriendly to the practice of medicine.

While there are numerous advantages for using EHRs, they are often criticized for slowing down physicians and for removing the personal element from doctor-patient care. Physicians do not want to be typists. A physician serving as a typist, or using point-and-click entry in the EHR, can be grossly inefficient. Physicians do not have the extra time to function as a data-entry clerk for the EHR. Rather, they prefer to spend quality time with their patients.

Medical Transcription Services, when integrated with EHRs, make EHRs much more efficient. Instead of typing their notes, physicians dictate using their preferred dictation method and the transcribed note is returned directly to the EHR within the contracted turnaround time (TAT). Transcribed reports are customized to the needs of the EHR and the physician, so they are personalized notes -- not cookie-cutter templates like many EHRs produce.

Transcription companies who employ discrete reportable transcription (DRT) can take the transcription-EHR relationship a step further by importing the transcribed information directly into specific fields or sections in the EHR. Gone are the days where transcribed reports become scanned attachments in the patient chart. Today, the transcribed information is incorporated directly into the medical record.

Medical transcription services make the use of EHRs more efficient, while preserving the personal element of doctor-patient interactions. In addition, transcription enables physicians to use EHRs and continue the workflow used today in their practice of medicine. Employing medical transcription services with EHRs benefits physicians and the patients they serve.

Is your EHR amplified with medical transcription?

This article was originally posted at http://ping.fm/1GMYM

Why you should opt for Online Medical Transcription

Medical sciences are seeing rapid advancements, and with these advancements come the need for comprehensive and accurate medical records that are vital for great quality healthcare. Medical transcriptions main purpose is to ensure accurate documentation of patient care, so that healthcare records can be saved and used for archives, reference, or as legal proof of medical advice.A growing and serious business ‘online medical transcription' refers to the outsourcing of medical transcription to differentmedical transcription office.

But first a little background into the entire service, Medical dictation is received in a digital format from the client (hospital or company), which is then transcribed by our qualified Medical Transcriptionists into a computer file. The transcribed computer file, often referred as Medical Transcript is passed on to the primary quality assurance team where qualified employees check the hard copy files for content and accuracy. Reports are then passed on to a second level quality assurance team, where the reports are randomly checked by our staff doctors. Once approved by our final QA teams, the reports are transmitted to the client in the specified format; this entire process is referred to as Medical Transcription Service.

One of the biggest benefits of outsourcing this service is that they are both cost-effective and convenient. Outsourcing companies can save both energy and time as well. Another major benefit of outsourcing medical transcription is that the healthcare organization would save on infrastructure, training and hiring of the right personnel to handle transcription needs. With the ever-burgeoning growth of the healthcare industry and the workload that has increased its dimensions in manifold, the healthcare units can outsource the work at a lesser price by cutting down on 40-60% of their costs.

India has become the most preferred destination for medical transcription outsourcing and it's no wonder then that Medical Transcription in India has become such a profitable market. In fact according to a latest Nascom survey the Indian Transcription Market makes between 220-240 million each year.

The medical transcription company that gets into a contract with the outsourcing company or companies has a team of transcriptionists who are versatile, talented and competent being trained in all medical specialties. This has added to the benefits as the main outsourcing company can be confident about the final result of the transcripts. These medical transcription companies have to adhere to the HIPAA and HITECH standards of the healthcare industry and conform to the safety and privacy of all medical records. The companies hence ensure that the medical transcription modules are processed and comply with these important standards.

With so many benefits listed above its no wonder that more and more companies offering medical transcription are now being formed. It's not only companies but a number of graduates are now looking for a career as a transcriptionist. The growth of Online Medical Transcription Outsourcing growth has surprised everybody but this is just the beginning for this industry.

CMS releases meaningful use proposed rule

The Centers for Medicare and Medicaid Services has laid out the details for how it will raise the bar for healthcare providers to qualify for incentives with the release Feb. 23 of its proposed rule for Stage 2 of meaningful use of electronic health records.

Among its provisions, CMS will delay the start of Stage 2 until 2014 instead of 2013.

As expected, the next stage of meaningful use builds on the criteria of the first stage, including increasing the threshold for performance of existing measures and pushing providers to actually exchange information in various transactions to drive continuous quality improvement.

In Stage 2, CMS said it would keep the same core-menu structure for required measures. Physicians will meet 17 core objectives and three of five menu options. Hospitals will meet 16 core measures and two of four menu options.

Health information exchange will be ramped up to a more “robust transitions of care” core objective, and the measure to provide patients with an electronic copy of their data is replaced by “electronic/online access” as a requirement.

The proposed rule had been widely expected sooner, and agency senior leaders faced disappointed crowds the day before at HIMSS12 without a rule in hand but gave them a “sneak peek” summary of the objectives.

The public will be able to comment on the 455-page proposed rule for 60 days after which CMS will finalize the regulation during the summer.

CMS decided to delay the onset of Stage 2 by one year to 2014 because the original 2013 timeframe does not give vendors enough time to design, develop and test new functionality and providers to deploy it and track measures over the one-year reporting period. As a result, Stage 1 is extended until 2014.

CMS is also trying to make the reporting of quality measures in 2014 easier for providers. For physicians, the clinical quality measures will align with existing quality programs, such as those used for the Physician quality Reporting System and CMS’ Shared Savings Program. For hospitals, the clinical quality measure will line up with the Hospital Inpatient Quality Reporting and the Joint Commission’s hospital quality measures.

Physicians will report 12 clinical quality measures, while hospitals 24. The agency also outlines how providers may electronically submit the quality measures, and. CMS wants public feedback on methods for it, including aggregate-level and group reporting options and through existing quality reporting systems.

Some of the core measures to meet during the reporting period include:
• More than 60 percent of medication, lab and radiology orders created by a provider using computerized physician order entry (CPOE)
• Implement five clinical decision support interventions for five or more clinical quality measures at relevant point in care; use functionality for drug-drug and drug-allergy interaction checks
• More than 55 percent of clinical lab test results whose results are positive/negative or numerical format are incorporated into EHR as structured data
• More than 50 percent of patients seen during reporting period are provided within four business days of visit online access to their information subject to provider’s discretion to withhold certain data
• Provider performs medication reconciliation for more than 65 percent of transitions of care in which patient moves into care of physician or admitted to hospital or ER
• Provider that transitions or refers patient to another care setting or provider supplies summary of care record for more than 65 percent of transitions of care and referrals
• Conduct or review security risk analysis, address encryption or security of data at rest and execute security updates as necessary and correct identified security deficiencies.

HL7 offers domain model for EHRs for free

LAS VEGAS – At HIMSS12 this week, Health Level Seven International (HL7) announced a pilot program that will offer some of its intellectual property, free of charge, in an effort to spur further EHR implementations.

“HL7 is keeping its promise to lower the barriers to adoption of electronic healthcare records by making portions of our valuable intellectual property freely available to our stakeholders,” said Charles Jaffe, MD, CEO of HL7.

“We believe that caregivers, academic centers and vendors will greatly benefit from this significant enhancement for access to valuable HL7 material,” he added.

Through the project, HL7 will open up no-cost licensing of its domain models (DAMs) and functional profiles. The offer is a first for the organization, officials say.

The DAM is a set of requirements that explore and analyze the business of a particular clinical “domain.” Domain analysis is the first step in creating HL7 standards for a specific care or research environment. The domain analysis process produces documentation describing the stakeholders, activities, interactions and information for a particular domain and serves as the source of requirements used in the design of HL7 standards.

Standalone DAMs will be made available at no cost during this one-year pilot, including:

• HL7 Version 3 DAM: Cardiology; Acute Coronary Syndrome


• HL7 Version 3 DAM: Clinical Trials Registration and Results


• HL7 Version 3 DAM: Analysis Model: Vital Records

Functional profiles for the HL7 Electronic Health Record System Functional Model (EHR-S FM) will be available as part of the pilot, too, officials say. The model was the industry’s first standard approved by the American National Standards Institute (ANSI) to specify the functional requirements EHR systems.

HL7’s functional profiles outline the important features and functions of an EHR system, such as criteria to support functions including medication history, clinical decision support and privacy and security. Profiles that are available to support specific uses across the continuum of care include child health, behavioral health, long-term care, clinical research and records management and evidentiary support.

“HL7 standards are the most widely used in the industry,” said Don Mon, chair of HL7's board of directors, who noted that they "will be especially useful to physicians, nurses and other health care professionals, as well as health information management/technology professionals."

Offering them free, he added, "will further our mission to enhance the exchange, integration, sharing and retrieval of electronic health information around the world.”

The HL7 DAMs and functional profiles can be accessed at HL7.org http://www.hl7.org/.

This article was originally posted at http://ping.fm/i9FrY

Article Asks: Is Shift Away from RHIOs Wise?

A recent article in the Journal of the American Medical Informatics Association explores changes in development of the Nationwide Health Information Network.

The authors question whether a shift away from regional healthcare information organizations to the use of point-to-point information exchange (such as the Direct Project) and private HIEs is wise. “We write this article to prompt a pause for reflection on the wisdom of this approach. We describe the history of RHIOs, the value of RHIOs to patients and communities, the changes in the policies of the Office of the National Coordinator, and likely the consequences of these changes. Based on this analysis we call for an open debate and the development of scientific consensus before irrevocable commitment to one model or another for the NwHIN is made.”

The de-emphasis on RHIOs is opening the door to private networks, such as those of delivery systems, networking firms like SureScripts and VisionShare, and electronic health records vendors, the authors contend. These networks have an advantage over RHIOs as they are not obligated to provide services necessary for a community health system or universal coverage for a region. “They can recruit participants based on favorable economics, reaping profits without having to meet the requirements for undertaking the truly difficult tasks in health information exchange. Further, health information exchange with business partners on private networks will likely meet proposed Stage 2 criteria for meaningful use incentives.”

Authors of the article are Leslie Lenert and David Sundwall of the University of Utah, a region served by the long-established Utah Health Information Network; and Michael Edward Lenert of the University of San Francisco. The article, “Shifts in the Architecture of the Nationwide Health Information Network,” is free here, but registration is required.

 This article was originally posted at http://ping.fm/Y5Nld

HHS Intends to Delay ICD-10 for ?Certain Health Care Entities?

The Department of Health and Human Services on Feb. 16 issued a statement announcing its intent to push back the Oct. 1, 2013, compliance deadline for ICD-10 “for certain health care entities:”

As part of President Obama’s commitment to reducing regulatory burden, Health and Human Services Secretary Kathleen G. Sebelius today announced that HHS will initiate a process to postpone the date by which certain health care entities have to comply with International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10).

The final rule adopting ICD-10 as a standard was published in January 2009 and set a compliance date of October 1, 2013 -- a delay of two years from the compliance date initially specified in the 2008 proposed rule.  HHS will announce a new compliance date moving forward.

“ICD-10 codes are important to many positive improvements in our health care system,” said HHS Secretary Kathleen Sebelius.  “We have heard from many in the provider community who have concerns about the administrative burdens they face in the years ahead. We are committing to work with the provider community to reexamine the pace at which HHS and the nation implement these important improvements to our health care system.”

Medical transcription outsourcing: A sustainable model for creating patient medical records

A commonly acknowledged fact about the healthcare sector is that it is a complex service involving a series of healthcare related and other factors that enable the delivery of quality healthcare on a timely basis. Therefore most healthcare facilities and healthcare professionals focus on lessening the burden of factors other than the actual process of healthcare on healthcare professionals and support staff. Creating patient medical records is one such function. It is essential for not only timely and efficient delivery of care, but also for other aspects like receivables management, risk management and meeting statutory obligations but is not part of the core functions.

Healthcare professionals and other support staff have various options for creating patient medical records, but over time medical transcription has proven to be one of the most efficient methods of documenting the care process. Moreover medical transcription is one such function that lends itself to being outsourced. Outsourcing medical transcription to a professional medical transcription company has many advantages one of the main being the sustainability of this model.

How do outsourcing transcription services provide sustainable support to healthcare facilities and healthcare professionals?

To understand how medical transcription services provide a sustainable model for creating patient medical records it is important to understand the main components of quality medical transcription. Quality medical transcription is defined as accurate, timely, secure and cost effective transcription. The main requirements for quality medical transcription are:

• Team
• Technology
• Processes

By outsourcing medical transcription to a professional medical transcription company, the onus of all these three resources is shifted to the medical transcription service provider, lessening the burden of healthcare facilities. However the process of choosing the right medical transcription service provider needs to be based on the right criteria to ensure seamless services.

Given below are the criteria on which the medical transcription company needs to be evaluated:

Team

• Sourcing: It is important to assess the service provider on the basis of their policy for sourcing and hiring the right talent. This needs to be continuous process to ensure that there is no dearth of medical transcriptionists to meet the changing needs of healthcare facilities and healthcare professionals.

• Developing: Once the right talent has been sourced it is important to provide these medical transcriptionists with the right training to ensure accurate and timely transcription. Considering that medicine is a vast subject with various specialties, it is important to train medical transcriptionists on different specialties based on their acumen to make them domain experts.

• Work allocation and continuous education: Apart from sourcing and developing the right talent it is important to allocate medical transcription work based on the specialty of medical transcriptionist team. It is also important to provide resources for medical transcriptionists to keep their knowledge updated.

Technology

• Maximum benefits: Considering the hectic work schedules of healthcare professionals it is important for medical transcription companies to use technology that provides maximum benefits. This should have options for collection of audio files as well as options for delivery of transcripts

• Easy to use: It is equally important for medical transcription companies to keep the technology as easy to use as possible to ease the burden on healthcare professionals and other support staff.

• Secure: Another aspect of the right technology includes providing security during the entire process of transcription

• Updated: Keeping in consideration the changing healthcare documentation scenario, medical transcription companies should constantly update technology and services to include the latest developments like HL7 interface, proofreading and editing services for speech recognition software transcription

Processes

• For quality: It is important to assess whether the medical transcription company subjects transcripts to multiple level quality checks to minimize errors
• For security: As protecting the confidentiality of patient information is both a legal and ethical responsibility it is important to source a medical transcription company who has processes in place to ensure HIPAA and HITECH compliance.

Medical Related Transcription Outsourcing ? Business Decision

When you are looking into how to educate yourself medical transcription, you’re usually looking to keep the prices down. When you land the position, your ability to help you type fast medical transcription training together with accurately becomes much more vital. No matter the route you decide to try locate your job of preference, using the Internet to take some action is beneficial as it will allow you to search a good deal of websites in much very less time of time. They’ve already toll free mobile and the physicians can use those for dictating. They do not touch patients but you have to understand the procedures regarding medical record documentation as they are dealing with top secret information. In truth an online health-related transcription course can be described as perfect fit for your military lifestyle, since the health related transcription online program eliminates a number of the burdens standing when it comes to a traditional health related transcription course. For that reason, you may find certification an improvement when operating coming from a home business natural environment.

Following some systematic and scientific method to outsourcing medical transcription can assist the healthcare premises avail maximum advantages of outsourcing option. Seeking to wrangle the most savings due to medical transcription services are probably not the obvious way to approach saving funds. However, for those who tend not to yet have any skill, you can visit and learn these folks. The person could be qualified from the twelfth grade in science that could be a basic requirement to your course. The corporation sector outsourcing MT services registered some considerable growth medical transcription schools within the last few few yrs despite global economic problems. Indians are by and large good at English language when compared with many other international locations like China.

Legibility – Accomplishing this of creating sufferer medical records makes certain that the audio within the patient- healthcare specialist encounter is neatly keyed in the appropriate review format/template. They convert the run information to documents then arrange them on files for painless retrieval. Assembly turnaround time standards would be sure the process connected with providing healthcare is unhindered and in addition ensure that the approach of reimbursement comes about on time. These types of documents are sent such as easily retrievable files for making the work simpler with the medical professionals. You will be also taught statement processing and keyboarding.

By exactly the same token, Medical Transcription, too is a simple growing aspect in the medical career arena. They guantee that they finish that shipment well in advance in order that the client does not suffer in the slightest degree. Consistency of information captured inside patient record is important as it affects both human eye healthcare as very well as reimbursements. Doctors are based upon those in medical transcription that provides reliable data as well as accurate translations through dictation. But there exists a need to use a record of those observations.

Medical transcribing India is 1 popular service that health centers and medical doctors are taking the benefit to transcribe this audio versions in to text format. These rules are essential when transcribing considering patient cases and even records especially medical care insurance medical transcriptionist salary records are influenced by law. It matches turnaround time criteria and which further facilitates the task of reimbursement in timely manner. Continuing to keep lower rates ensures that you receive more clients and makes certain that your clients stay loyal too. Characteristics like uploading audio recordings, downloading transcripts, tracking patient archives, adoption to EMR, varied modes regarding document delivery, HIPAA/ HITECH compliance while in the transcription process is going to be provided for with the service provider. When you’ve your medical transcribing certification you have the capacity to work for many companies such because hospitals, private doctor’s practices, medical insurance companies and much more.

Guest post by Loguidice P. Greg Orem

Medical transcription services are inexpensive

I started off gradual and gradually figured out their process. I did start out getting my treasured medical professionals and my manufacturing elevated. I was getting the dangle of it and getting compensated for it! I was so proud that I accomplished some thing I set out to do. I labored 3-1/two decades for this business, which in some occasions is a long time contemplating it was my initial and only business I labored for. I was concentrating on specialties that interested me. I acquired to cherry decide some of my treasured medical professionals. I was pleasantly stunned that my treasured specialties turned out to be cardiology and psychiatry. In my impression, if you are doing work on specialties that bore you to tears, or provide you to tears for that make any difference, then the career turns into additional of a chore fairly than a enthusiasm, which brings me to the not-so-nice half of my encounter.

Medical transcription expert services have turn into pretty much indispensable in fast paced health care settings, where by medical professionals have to commit most of their time to affected person care. Accurately transcribed medical reviews that are neatly organized, managed and easily available can help doctors have a very clear thought about the therapy remaining supplied to their patients and even boost the quality of affected person care. Consequently additional and additional medical professionals and health care establishments are based on medical transcription companies that can provide precise and timely expert services. Before entrusting your medical transcription to this sort of a business, you ought to know what to assume and search for in a reputable service provider.

With the abundance of on-line resources, alongside with effectively-respected organizations like AHDI and MTIA, the medical transcription industry is steadily getting to be a significant presence in the medical field. Not only are there a lot of employment for MTs, but there are also quite a few organizations that are advocating for the career, which is earning additional respect in the medical field yr right after yr.

Health care transcription is easy and all can be a transcriptionist: This is a typical medical transcriptionist salariesfalse impression about transcription, presented that entry into this occupation is comparatively easy. No recognized qualifications are necessary apart from for a grasp above for the English language, fantastic typing aptitude and a keen ear. In spite of the easy entry to satisfy the standards as a medical transcriptionist, an personal has to be subjected to exhaustive training in medical phrases, procedures and medication. This career also desires men and women to frequently teach by themselves on the most recent progress in the medical industry

Subsequent, a medical dictionary is also a fantastic Become A Medical Transcriptionist merchandise to have in your workplace. You can obtain Medical Transcriptionist Companies numerous used dictionaries at bargain rates on Amazon. Lastly, as with any career where by you sit and kind a good deal, make investments in a cozy chair and desk. You may also want to consider a search at wrist help or an ergonomic keyboard. These will spend for by themselves in the long run.

3. Neighborhood Doctors Offices – It s true, there are plentitude of doctors offices in your group that would like to retain the services of anyone to do the job from bag for them because most are in dire need to have of quality transcriptionists. When you go to implement, just provide a double of your uphold and cover letter rank with your degree of endure and evidence of certification. That ought to be all you need to have to intend the career.

The reason we have established this nice little history is not to start out nevertheless yet another discussion on funds vs. enthusiasm, but to introduce you to this career referred to as medical transcription and help you have an understanding of where by you stand fiscally ought to you pick out this career.

The Health Career Institute is usually a exceptional possibility for doctors and those in hospital administration seeking to train and train medical transcription by by themselves.They are a modest but incredibly influential and hugely regarded publishing organization within the medical information self-control. Countless numbers of medical transcriptionists throughout the English-speaking planethave figured out medical transcription with their recourses. The SUM Method for Medical Transcription Teaching, developed by Health Professions Institute (HPI), stands out as the foremost medical transcription schooling application used in faculties, non-public hospitals, and transcription companies throughout the English-speaking globe. The SUM Software is also available to men and women who are contemplating self-directed examine. So have a search at their site

We feel to be a really disenchanted group with the current solutions in professional associations, based on the responses about why we will not belong or why we depart. In that question, we figured out that quite a few will not sense it has made a difference or held a reward for them, though many others felt the desires of the personal MT are no more time addressed.

Benefits Of A Medical Transcription Service

Managing of people; keeping of records; upgrading your process, technology, maintenance, tools and equipment; keeping up with your turn around time; and all other variables involved in the medical transcription makes and takes a lot of time, effort and money. A timely billing and account reimbursement is directly correlated to strengthen the financial aspect of your health care business. Here are some of the benefits that your health care facility will enjoy because of a

1. High quality and accurate medical records. There are standards and certifications that each medical transcription service must follow thus managing your medical records are of high quality and are done accurately. You will not worry on editing, reviewing of records and proofreading. All of these are managed and handled precisely. A group of quality assurance professionals will measure performance and will impose penalties and sanctions to make sure that prescribed quality levels are achieved and turnaround time are adhered to. There are a lot of benefits of acquiring such service.

2. Reduced administrative costs. The hiring process must be scrutinized. In order to get better results, the hiring process must be thorough and precise making sure that only the best are being hired to provide better output. Medical transcription service will help reduce all these administrative costs while providing the best and accurate service.

3. Cost effective. As mentioned, labor costs, training costs and maintenance on equipments and tools are expensive. Medical transcription service will take good care of all these and at the same time will provide you with a better service.

A carefully selected transcriptionist with a passion of quality must be selected in order to get quality result of your physical or discharge reports. Another area that you must consider is the security and confidentiality of your patient's records. The service provider must have a process that is as straight forward as possible in handling a high security level so that any personal information is kept confidential. Customers will remember you and would want to come back if they get the kind of service that they expect. Finding the best professionals who can do a medical transcription service is one of the most important decision a physician can do. So instead of worrying on how to get the reports done or on how to make sure that the records are accurate and on saving administrative cost start checking the best medical transcription service, today.
Author:Fernando Morados
Source:http://ping.fm/LREW6

AHIMA: Time to think about training - and keeping - your coders

LAS VEGAS – The enigmatic duration of HHS’ intended delay of ICD-10 is giving payers and providers hope for a little breathing room when it comes to training coders – but it simultaneously creates a need to ratchet up employee retention efforts.

As such, providers need to plan for both training and retention regardless of what new deadline HHS might issue for ICD-10 compliance, said Bonnie Cassidy, AHIMA past-president during a presentation at HIMSS12 on Wednesday.

Some coders, for instance, learned ICD-10 decades ago via on-the-job-training, others came out of college programs, and while those different coders might have different approaches to learning ICD-10, many will likely need Anatomy and Physiology training in order to use ICD-10, be it for the first time or as a refresher.

How much time will you dedicate to training? Will you enable them to learn ICD-10 on the job, or expect that they do so on nights and weekends?

And how much will it cost? Cassidy pointed to an AHIMA survey of 600 HIM directors that found “hospitals may be greatly underestimating the amount of money it will take to train coders for ICD-10-CM/PCS.”

Many are thinking it will cost $2,000 per coder. Cassidy recounted one HIM director who put in a $2,000 budget request for training each coder, and got back $400.

“It’s not going to get done for $100,” Cassidy said.

Alongside the training Cassidy urged attendees, in turn, to consider retention – most important once the training and certification money has been spent.

“What are you doing to keep employees that have been trained and certified?” Cassidy asked. “You have to know your staff.”

Indeed, some providers are already seeing ripple effects of the delay particular to staffing. Tom Pacek, CIO of South Jersey Healthcare during a panel discussion in Monday’s ICD-10 symposium that, despite a new compliance deadline, his hospital plans to push forward – but that talk of the push back has already made it harder to convince human resources of the need to replace some coders that recently left their jobs. “This has created more headaches for me,” Pacek sad.

Dispelling myths about EHR and up-to $44,000 ARRA incentive

As you likely know, 2011 was the first pay-out year for doctors choosing to implement EHR (electronic health records) and choosing to take advantage of up to $44,000 in ARRA incentives. Over $2 billion has already been paid to providers and hospitals for achieving meaningful use in 2011. That includes chiropractors.

I've been fortunate to be involved in the entire process, including interacting and meeting at HHS with many of the decision- and policymakers in Washington, D.C., regarding adoption of EHR and technology's connection to it.

Unfortunately, there is still a great deal of misinformation out there about the incentive and EHR in general.

Following is a list of the greatest myths I've encountered ... and the truth behind them:

MYTH: Chiropractors are not eligible for the up-to-$44,000 incentive for implementing certified EHR software.

FACT: The government uses the definition of "physician" from the Social Security code, which includes chiropractic physicians. Thus, doctors of chiropractic are eligible to receive reimbursement for implementing EHR, as long as they meet the other established guidelines.

In fact, hundreds of Future Health DCs have already gone through the processes of implementation and attestation—in addition to our Meaningful Use Workshops—and have received their 2011 payments.

You can still receive the full incentive by starting in 2012 and performing meaningful use for just 90 days in your first year.

MYTH: Any electronic system will qualify me for reimbursement.

FACT: Only CERTIFIED EHRs that are used in a meaningful way will be considered for incentive payments.

It's important to note that there are two distinct classifications of Certified software: Modular and Complete.

EHR with Complete Certification—like Future Health eConnect and CVOS—can help you qualify for up to $44,000 using just that software. Future Health eConnect and CVOS received Complete Certification July 21, 2011.

Other EHR software with Modular certification requires you to find complementary software to piece together with the modularly certified software in order to be eligible.

MYTH: If I choose not to implement EHR in my clinic, nothing will happen to me.

FACT: Beginning in 2015, penalties will be assessed to doctors who choose to not transition to electronic health records. The penalties will be in the form of Medicare reimbursement payment reductions.

MYTH: I will only get reimbursed for the amount I spend on my EHR software.

FACT: The incentive payment amounts have been set by the federal government and have nothing to do with how much you spend on your EHR.

The government wants to motivate doctors to implement an EHR as soon as possible, and has created a strong financial incentive plan to move the process forward swiftly. The sooner doctors implement, the more incentive payments they can receive. The chart included with this column shows that incentive payments may be as high as $44,000, a substantially higher benefit than the average cost to implement a system.

Here's how the payments break out –



The government recognizes that there are hardware costs, training costs and possible revenue

loss during the initial conversion to your new system, and those costs have accounted for those costs in the $44,000 incentive payments.

MYTH: Individual doctors do not receive incentive payments for implementing EHR, but rather the clinic.

FACT: The incentive payments program has been set up to benefit individual eligible providers specifically. This means that several DCs who practice in the same clinic can each qualify for incentive payments, as long as all the individual doctors are using a qualified system meaningfully, according to the incentive payments requirements.

MYTH: Now that the government is incenting all eligible providers to adopt EHR, the government will be able to dictate how we deliver care.

FACT: Nowhere in any of the legislation does it indicate that the government will impose on the methods of delivery of patient care. Rather, an agency called the Office of the National Coordinator of Healthcare Information Technology (ONCHIT) was established in 2004 to facilitate the implementation of EHRs across healthcare entities.

The office is only given authority to organize the implementation process, and is not charged with overseeing actual delivery of care and how you treat patients.

There's still time to take advantage of the full $44,000.00 incentive

The government decided earlier this year that eligible providers—including DCs—could still qualify for the full $44,000 incentive if they implement a Certified EHR in 2012 and demonstrate 90 consecutive days of meaningful use.

That means there's still time to take advantage of this incentive for doing something many of us know we should be doing anyway.

For detailed information about the EHR/ARRA Incentive, sign up for a free, no-obligation webinar now atwww.FHeConnect.com.

About Steven J. Kraus, DC, DIBCN, CCSP, FASA, FICC

Steven J. Kraus, DC, DIBCN, CCSP, FASA, FICC, is founder and CEO of Future Health - the nation's #1 provider of chiropractic-specific EHR/practice management software. Future Health software is ONC-ATCB Certified as a Complete EHR, helping you qualify for up to $44,000.00 in EHR/ARRA incentives. Sign up for a free software demo and ARRA update now at www.FHeConnect.com or call Toll Free 1-888-919-9919, ext. 656.

Dr. Kraus is an acknowledged expert in Health IT, including EHR (electronic health records) and the up-to-$44,000 ARRA incentive program to implement EHR.

He has served and continues to serve on numerous committees and boards, including:

• Electronic Health Records Committee for the ACA

• Past President of Iowa Chiropractic Society

• Past Chairman and Board Member of the Iowa Board of Chiropractic Examiners

Dr. Kraus frequently travels to Washington D.C. to represent the chiropractic profession, helping ensure DCs are considered in healthcare discussions and policymaking.

He is also an expert on practice management, with more than 23 years' experience in his own practice. He has developed and sold 18 practices and has provided strategic consulting to more than 400 healthcare businesses nationwide. He lectures to state associations and at industry events regarding EHR and the relationship to documentation, and he presents monthly webinars on how EHR usage will impact doctors of chiropractic.

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HHS Intends to Delay ICD-10 for ?Certain Health Care Entities?

The Department of Health and Human Services on Feb. 16 issued a statement announcing its intent to push back the Oct. 1, 2013, compliance deadline for ICD-10 “for certain health care entities:”

As part of President Obama’s commitment to reducing regulatory burden, Health and Human Services Secretary Kathleen G. Sebelius today announced that HHS will initiate a process to postpone the date by which certain health care entities have to comply with International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10).

The final rule adopting ICD-10 as a standard was published in January 2009 and set a compliance date of October 1, 2013 -- a delay of two years from the compliance date initially specified in the 2008 proposed rule. HHS will announce a new compliance date moving forward.

“ICD-10 codes are important to many positive improvements in our health care system,” said HHS Secretary Kathleen Sebelius. “We have heard from many in the provider community who have concerns about the administrative burdens they face in the years ahead. We are committing to work with the provider community to reexamine the pace at which HHS and the nation implement these important improvements to our health care system.”

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Smart Content Reviewed: Text Analytics & Semantic Content Enrichment&

Spurred on by an online debate about the distinction between text analytics and semantic content enrichment, I turn in this article to the pressing question: "What does semantic content enrichment mean?"

As IBM's Marie Wallace remarked, it’s great to see the term semantic content enrichment generating discussion although, she continued, "I suspect that most people still don’t differentiate it from just text analytics."

The Distinction
Oh, but there is a difference. Let’s explore it via the definitions that follow, first of text analytics, then content analytics and finally content enrichment and where the ensemble takes us.

First definition:

Text analytics is a set of software and transformational steps that discover business value in “unstructured” text. (Analytics in general is a process, not just algorithms and software.) The aim is to improve automated text processing, whether for search, classification, data and opinion extraction, business intelligence or other purposes.

To expand on this definition a bit, to bridge from text to the wider content world:

Text analytics draws on data mining and visualization and also on natural-language processing (NLP). Supplement NLP with technologies that recognize patterns and extract information from images, audio, video and composites and you have content analytics.

The concept of content enrichment is easy to grasp: Every link in this article — Web links are accomplished via the HTML “a” anchor tag — is a bit of content enrichment. And semantic content enrichment? Marie Wallace puts it this way, focusing on text but with concepts that extend to the broad set of content types:

When I think about semantic enrichment, I see it as transforming a piece of content into a linked data source. In order to do this you do indeed need text analytics for entity and relationship extraction, but you need more than that…. A text analytics engine might recognize that [Marie Wallace] is a person, [Ireland] is a place, and Marie comes from Ireland and annotate the entities/relationships found. However when doing semantic enrichment, I would want to convert those annotations to openly addressable URIs that contribute to the linked data cloud.

URIs are uniform resource identifiers, Semantic Web terminology for IDs, unique within a namespace, that name or locate things. Web URLs (e.g., http://whitehouse.gov/) are a type of URI.

Rather than write my own annotation elaboration, I’ll reuse one from Ontotext, a semantic-technology developer:

Annotation, or tagging, is about attaching names, attributes, comments, descriptions, etc. to a document or to a selected part in a text. It provides additional information (metadata) about an existing piece of data.

Semantic Annotation goes one level deeper:

• It enriches the unstructured or semi-structured data with a context that is further linked to the structured knowledge of a domain.


• It allows results that are not explicitly related to the original search.

The earliest specific semantic content enrichment reference I’ve encountered is in an Ontotext paper, Towards Semantic Web Information Extraction, presented at the 2003 International Semantic Web Conference (ISWC).


The paper covers work based on Ontotext’s Knowledge and Information Management (KIM) platform, which in turn relies on GATE, the General Architecture for Text Engineering, an open-source text-analysis framework and toolkit, Apache Lucene and other technologies. The Ontotext folks have other, related papers posted on the company Web site.

Complementary Processes

The Ontotext materials help explain the role text/content analytics can and should — but doesn’t often enough — play as a Semantic Web generator. The entities, concepts, events and other features discerned, via content analytics, in text and rich media not only enable smart content; they can also be loaded to knowledge bases (which I won’t get into here, other than to say that systems such as IBM Watson and Wolfram Alpha use them) and Semantic Web triple stores.

There are other solution providers in the content analytics meets semantic annotation/enrichment game. In addition to IBM and Ontotext, they include HP Autonomy, MarkLogic, OpenText, Temis and the nascent, open-source IKS project. Other vendors offer enterprise-strength building blocks, for instance, SAS via the various SAS Text Analytics components.

I’m sold on this stuff given the business benefits for content producers and content consumers alike. These technologies — and the interplay between analytics and semantics — are key in making sense of the digital universe.

Editor's Note: You may also be interested in reading:

• Taxonomy Building: Tackling the Challenges by @buckleyplanet


• IKS Means Semantic Intelligence for Content Management, But Will it Survive? by @sethgrimes


• Auto-Classification: Friend or Foe of Taxonomy Management? by @stephlemieux

About the Author
Seth Grimes is an analytics strategist with Washington DC consultancy Alta Plana Corporation. He is contributing editor at InformationWeek, chairs the Sentiment Analysis Symposium and the Text Analytics Summit, and is the leading industry analyst covering text and content analytics.

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Modularity requirements in bio-ontologies: a case study of ChEBI

Modularity requirements in bio-ontologies: a case study of ChEBI

A wish list for tools for modularity support in bio-ontology engineering based on the ChEBI ontology requirements. Presented at the workshop on modular ontologies, WoMO, 2011, in Ljubljana.

HIT Today: Increase your income through quality reporting

In the "real" world, people expect to pay more for something if it's of higher quality or offers superior performance. That free-market standard promotes higher-quality products and services.

The healthcare industry, however, generally does not operate in this manner. Patients have few options for "kicking the tires," so to speak, before electing to start a drug treatment, undergo surgery or therapy, or choose a physician.

This inability to get a reading on the effectiveness of drugs and treatments hinders those tasked with improving the overall effectiveness of the healthcare industry. Thus, the government created pay-for-performance programs to incentivize you and your colleagues to collect and submit data on the outcomes of the drug treatments and procedures performed on your patients in anticipation that these programs would lead to evidence-based clinical guidelines that will improve the quality of care you deliver.

SHOULD YOU PARTICIPATE?

One reason to consider a pay-for-performance program is to join in the movement to improve healthcare in this country. Another is to make more money. And there's nothing wrong with that.

Healthcare can be a difficult industry in which to make a living. As reimbursement rates continue to shrink, programs such as the Physician Quality Reporting System (PQRS) provide opportunities for you to maintain your revenue.

The government launched the PQRS (formerly called the Physician Quality Reporting Initiative, or PQRI) program in 2006 so it could collect data on which drugs and treatments illicit the best outcomes and create evidence-based clinical guidelines to improve medical treatments. Doctors participating in Medicare Part B who choose to participate in the PQRS program can receive annual incentive checks equal to 0.5% of their Medicare Part B claims. They can earn another 0.5% when they also participate in a maintenance of certification (MOC) program for a year ("more frequently than is required to qualify for or maintain board-certification status") and successfully complete a qualified MOC program practice assessment for such year. No sign-up or pre-registration is required to participate.

What is an MOC program? Defined in the Social Security Act, an MOC program is "a continuous assessment program that advances quality and the lifelong learning and self-assessment of board-certified specialty physicians by focusing on the competencies of patient care, medical knowledge, practice-based learning, interpersonal and communication skills, and professionalism." Learn more athttps://www.cms.gov/PQRS/Downloads/2012_Maintenance_of_Certification_Requirements_2.pdf.

WHAT TO REPORT, AND HOW TO REPORT IT

Once you fill out the required self-nomination forms, you will select at least three measures to submit for consideration from the 2012 PQRS measures list. The list is in PDF format (along with other information you'll need to read) in the "downloads" area at the bottom of the "how to get started" page of the Medicare PQRS Web site, http://www.cms.gov/PQRS.

It's important to read these documents. They outline the codes you'll use to record the patient data and the methods by which you can submit them to CMS.

To qualify to receive the annual incentive check, physicians participating in Medicare Part B first must determine whether a claims-based or registry-based method of reporting best fits their practices. That choice will determine whether the reporting period will be 6 months or 12 months.

If you select the claims-based method, then you will add the PQRS reporting data to your Medicare Part B claims. If you select the registry-based method, then you will give your PQRS reporting data to the group that administers a qualified registry. The group then will submit those data on your behalf.

USING YOUR EHR TO SUBMIT PQRS DATA

This year, CMS added a third method for submitting patient PQRS data: the electronic health record (EHR) system. CMS qualifies EHR direct vendors and their products to participate. In addition, systems must:

• be able to collect and transmit all required data elements according to the 2012 EHR data submission specifications;


• be able to separate out and report on all Medicare Part B physician fee schedule (PFS) patients only;


• be able to include tax identification number/national provider identifier information submitted with an eligible professional's quality data;


• be able to transmit those data in the CMS-approved format;


• comply with a secure method for data submission;


• not be in a beta test form;


• have at least 25 active users;


• be able to report (and test submission) for all 51 e-specified measures;


• be able to report only the measures selected by the eligible professional; and


• report only those data elements (in a Quality Reporting Document Architecture level 1 format) needed to calculate the measures (if possible).

Also, each qualifying vendor must participate in mandatory support conference calls hosted by CMS (approximately one per month) and indicate the reporting options it seeks to qualify for its users to submit, including individual measures and e-prescribing for individuals and groups.

Knowing these requirements can help you when selecting an EHR for attesting to meaningful use.

ARE YOU ELIGIBLE?

With some exceptions, basically all doctors who bill directly for Medicare Part B payments under the Medicare PFS can participate in the PQRS program and earn the 1% incentive check for both successfully reporting PQRS data and for participating in an MOC program.

Physicians eligible to participate include doctors of medicine, osteopathy, podiatric medicine, optometry, oral surgery, dental medicine, and chiropractic. Other eligible practitioners include physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists (and anesthesiologist assistants), certified nurse midwives, clinical social workers, clinical psychologists, registered dietitians, nutrition professionals, and audiologists. Physical therapists, occupational therapists, and qualified speech-language therapists also may participate.

Medical professionals cannot participate in these programs if they are paid under or based on the PFS-billing Medicare carriers/Medicare administrative contractors (MACs) that do not bill directly, or if they are paid under PFS-billing Medicare fiscal intermediaries (FIs) or MACs. That's because the FI/MAC claims processing systems currently cannot accommodate billing at the individual physician or practitioner level.

PROGRAM IS VOLUNTARY

Currently, the PQRS program is voluntary for doctors. If, however, you become involved with a Patient-Centered Medical Home or an accountable care organization, both of which engage in quality reporting as part of their revenue-generating procedures, then collecting and submitting drug treatment and prescription data, as well as patient outcomes, could become a mandatory part of your practice.

You will find PQRS program specifics for this year athttps://www.cms.gov/PQRS/03_How_To_Get_Started.asp#TopOfPage.

This Article Original Post at Medical Economy 

The EHR and ICD-10 Connection

An article by Ron Sterling from the January/February 2012 issue of HBMA Billing.

The upcoming ICD-10 start date of October 1, 2013 creates a critical path that can affect the EHR strategy and plans of you and your clients.

For many third party billers and their clients, the months leading up to ICD-10 start date will be focused on two major tasks.

• Implementing last minute changes to EHR systems and interfaces with practice management systems. EHR systems currently use ICD-9 codes for a variety of purposes. The use of ICD-10 codes in place of ICD-9 codes could have a variety of unintended consequences and force substantial changes in EHR systems. For example:

1. Many EHR systems leave the coding of modifiers to the companion billing systems. If the ICD-10 code is determined by the EHR, then the EHR should also establish the matching CPT codes and modifiers.


2. ICD-9 codes are used to organize the patient record and support coding of charges. For example, many EHRs use ICD-9 codes to index patient problems, which can have associated prescriptions, orders, and images. If the ICD-9 classifications are switched to the ICD-10 system, then the relevant parts of the ICD-10 codes will vary for the related ICD-9 classification.


3. ICD-9 codes associate related visits and other information within the EHR. For example, you can view all exams dealing with a specific ICD-9 code. If ICD-10 codes are used, the EHR will need a facility to relate the relevant portions of those codes with historically-classified ICD-9 information.


4. ICD-9 codes trigger patient care items. For example, an ICD-9 code for diabetes may trigger a health maintenance item associated with a periodic lab test. The logical constructs used by EHR systems will have to be reworked in order to be triggered by new ICD-10 codes.

• Implementing changes to PMS and billing procedures and systems. In addition to focusing on correct coding, third party billers and practices will want to closely monitor the performance of their clearinghouses and payers for initial problems and evolving issues in the switch to ICD-10. For example, payers may strengthen the edits between the ICD-10 and CPT codes over time. Third party billers and their clients may have to deal with an ever increasing number of payer specific requirements.

With this substantial body of work waiting to be completed, third party billers and their clients cannot assume that conversion of paper patient records to EHR projects can be accomplished in the same time frame. Indeed, proper completion of a practice's EHR implementation may be a critical path item to start the rollout of that client's ICD-10 solution.

Third party billers should work with their clients to pace the implementation of EHR strategies for a smoother transition throughout the ICD-10 process. Practices may fail to meet the ICD-10 requirements and disrupt cash flow after October 1, 2013 and third party billers may be unable to pursue EHR opportunities when the ICD-10 transition is underway. Consider the following timeframes as you plan your internal strategy or in your work with your clients:

• Selection of PMS and EHR products can take 2 to 4 months or more before a decision.


• Contract negotiations and planning can consume another 30 days.


• Implementation of an EHR can take 4 to 6 months depending on a variety of policy and implementation issues. For example, it can take 30 to 60 days to install the hardware base and provision upgraded communications.


• Once the EHR implementation is complete, a practice will need 4 to 8 months to transition individual patients to the EHR.


• If you are considering a new billing system as part of your EHR project, allow an additional 4 to 6 months for the project.

A full PMS / EHR project can take anywhere from 10 to 18 months or more. Considering that practices and your organization should be ready to focus on ICD-10 by the beginning of summer, 2013, it is not too early to tackle the EHR project on your critical path to ICD-10 compliance.

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