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The Latest on Public Health Data Reporting and Stage 2 Meaningful Use

family practice EHR softwareWe’ve discussed before on this blog how electronic health records — anything from family practice EHR software to large hospital systems — can, in theory, contribute to public health goals by facilitating large-scale epidemiological analysis and similar projects. That’s one more reason, besides the fact that they increase efficiency by about 6% annually, for healthcare providers of all sizes to consider them. And, in fact, it appears that most are: As of 2013, 78% of office-based physicians reported using EHR or EMR software, as opposed to only 18% in 2001. Moreover, more and more providers are focusing on meeting federal meaningful use criteria, with about three-quarters of current EHR users saying their systems are up to that standard.

But has it actually been shown that electronic records do improve public health reporting? As of last month, the answer is yes.

Hospital Reporting
According to data released by the Office of the National Coordinator for Health IT (ONC), hospitals meeting Stage 2 meaningful use criteria were able to significantly increase their electronic reporting of health data to registries and public health agencies in 2014. “These data clearly demonstrate that public health agencies and hospitals are capable of exchanging electronic health information,” Dawn Heisey-Grove of the ONC told industry website “Adoption of electronic health records … and other health IT has made it possible to shift from time-intensive, paper-based public health reporting to electronic information exchange, which enables sending more complete information to public health agencies faster.”

Reporting Details
What were these hospitals better and faster at reporting? There are three major public health aspects that factor into Stage 2 meaningful use (reporting was optional in Stage 1). The latest data from the ONC show that 88% of Stage 2 hospitals electronically reported to immunization registries, 85% electronically reported their lab results, and 75% electronically reported their syndromic surveillance. Additionally, 70% of medications administered were electronically tracked, 36% of patient transitions were accompanied by electronic summaries, and 15% of patients downloaded or transmitted their own electronic health data.

Limited Scope
It’s important to note that this analysis only included data from hospitals using Stage 2-compliant EHRs. That doesn’t mean that the family practice EHR software used by small practices can’t also help in public reporting goals, it just means this particular analysis hasn’t addressed those contexts. The other major step that needs to be taken, Heisey-Grove said in the interview, is assessing whether public health reporting directly leads to better public health outcomes.

Are you looking for family practice EHR software, records for a more specific specialty or complete practice management software? Discuss your software needs in the comments.

Warning Signs You’re Choosing the Wrong Medical Software Company

virtual practice management software

Electronic medical records and their slightly more comprehensive siblings, electronic health records, are getting better. While many physicians used to focus on bare-bones basic systems — adoption of basic systems by office-based physicians went up 21% between 2012 and 2013 alone — practices are getting smarter about choosing systems that will set them up to receive federal incentives and improve their overall efficiency. Currently, about three-fourths of physicians with EHR systems report that they’re capable of demonstrating “meaningful use” as defined by federal departments.

But if you’re looking at medical software companies for the first time, it can still be very overwhelming, especially since choosing the wrong one to handle your EHR or EMR software can be a very expensive mistake. Here are five red flags to watch out for:

  1. They Don’t Integrate All Your Systems
    If you’re just looking into medical software solutions now, a basic electronic record system probably isn’t the best route. Instead, you should be looking for a complete virtual practice management software that will digitize your records but also facilitate appointment scheduling, ordering and billing. There’s simply no reason not to integrate all those tasks.

  3. They Have Zero Clients in Your Specialty
    When it comes to record-keeping, different things tend to matter more in different specialties. If a software company has no clients with your same specialty, you may want to turn to a company with more experience within your narrower scope.

  5. They Don’t Run or Help You Run Reports
    One of the incentives of using virtual practice management software is increased efficiency; complete electronic record-keeping has been shown to improve overall efficiency by 6% annually. But one way you can improve your processes is by being able to see compiled data more clearly, and that means it should be easy for you to pull reports at any time.

  7. They’re Stingy With Their References
    If a medical software company either won’t give you direct references or will only give you a very limited pre-printed list of references to contact, that’s a bad sign. Privacy is important in the medical world, of course, but that really shouldn’t affect your being able to talk to other physicians who have used a company’s software.

  9. They Offer Very Limited Customer Service
    Virtual practice management software has the capability to transform the way your practice operates. But a software system like this is complicated, and it’s not something you should expect to just install and use with no direction. You should be choosing a company that offers training and extensive ongoing support.

Can you think of any other signs of a good or bad medical software company? Join the discussion in the comments.

7 Signs Your Current EMR System Needs Replacing

EMR practice management software

Electronic medical records or electronic health records are virtually ubiquitous. As of 2013, the percentage of office-based physicians using an EMR/EHR system had risen to 78% — from only 18% in 2001. Moreover, more than half of the physicians without an electronic record system are planning to purchase one or start using an already purchased one within a year.

But, as you unfortunately may have experienced, sometimes buying a software system is just the beginning of your problems. Here are seven signs that you’re better off starting over with a new EMR provider:

  1. You Won’t Make Meaningful Use
    If you’re hoping to reap the financial benefits of federal incentive programs, then this one should be a no-brainer: If your current EMR system doesn’t meet federal criteria for “meaningful use” (qualifying you for those financial benefits), then you need to find one that does.
  2. You Enter Things Twice or More
    Combined EMR practice management software is supposed to make your life easier by keeping track of records, scheduling appointments and integrating billing systems. If you’re having to enter information into separate systems to manage all those functions, you should know there are more efficient options available to you.
  3. You Can’t Order or Prescribe
    You should be able to do ordering and communicate with pharmacies directly from your EMR software. This can save you quite a bit of time in the long run, so you shouldn’t be content to live without it.
  4. You Constantly Find New Fees
    Getting a top-notch EMR system can cost quite a bit (although it doesn’t have to). However, you should know exactly what you’ll be paying from the start. If you’ve already shelled out as much as you can afford and are still finding new fees, then you should be looking at different medical software companies.
  5. You Get Very Little Support
    Switching to EMRs can be a frustrating and time-consuming process; in 2014, a American College of Physicians member sample survey found that family practice doctors spent 48 more minutes per day on EMRs. The way to avoid this type of slowdown and see better efficiency, instead, is to get training and support from your software provider. If they’re not willing to offer that support, you should be running in the other direction.
  6. You Can’t Use Multiple Devices
    What good is an EMR if you can’t access it from whichever device is most convenient for you? You should be able to work on computers, tablets and even smartphones if you so desire.
  7. You Miss Your Manila Folders
    It takes time to adjust to a new way of doing things, and it’s normal to have a little nostalgia for your pen and paper once in a while. But if you actually wish that you could go back to the days of drawers and drawers full of manila folders, then something about your EMR practice management software simply isn’t doing its job.

Are you worried you’re using the wrong combined EMR practice management software? Join the discussion in the comments.

3 Reasons Your Electronic Medical Records Might Be Making You Miserable

electronic medical recordsDespite some undeniable challenges in their implementation, electronic medical records/electronic health records have made great strides in the past few years. Between 2010 (the first year from which trend data is available) and 2013, there was a significant increase in physician adoption of EHRs capable of meeting Stage 2 meaningful use as defined by the federal government; now, about three-fourths of physicians with EHR systems report that their system meets meaningful use criteria.

But are electronic medical records actually making life better for physicians? Not everyone is so sure. As Eric Wicklund, editor of industry site mHealthNews, noted March 11, “Doctors are miserable, and technology isn’t helping.” He cites a recent study from Geneia that says that more doctors are miserable in their practices than are satisfied, saying that regulatory burdens and technological overloads are contributing to that misery. In the long run, everyone hopes that technology will ease burdens on doctors, he writes, but that’s not presently the case.

There’s another way of looking at this information, though. It could be that some practices are overlooking very simple ways of improving their EMR software experiences without having to wait for overhauls years down the road. Here are three reasons why your EMR might currently be making you miserable — and how to fix the problem:

  1. You’ve Not Using the Right EMR
    One of the simplest explanations for your EMR not working for you is that you might be using the wrong EMR. Not all software is equal in quality, and you may have an even harder time finding software that meets your needs if you work in a narrow specialty. If that’s the case, changing EMRs might be the best decision in the long run.
  2. You’re Not Training Your Staff
    Like most tools, EMRs require user training in order to be effective. It’s normal to see an initial slowdown when implementing any sort of new procedure, but you should soon see efficiency improve dramatically as long as proper training measures are in place. If that doesn’t happen, it’s time to think about retraining (ideally with the help of your EMR developer).
  3. You’re Not Changing Your Mindset
    Entering information into EMRs can take longer, it’s true; a survey done in 2014 of the American College of Physicians member sample found that family practice doctors spent 48 extra minutes per day on EMRs. But that’s only a problem if EMRs are merely accounting for the exact same information as old-fashioned paper charts. In most cases, EMRs can do significantly more (and lead to greater efficiency and better care down the line), which means it’s not necessarily a bad thing to spend a little extra time on them.

Are you currently using web based electronic medical records in your practice? Use the comments to let us know about any problems you’re experiencing with your medical software systems.

The Medical Technology Revolution: How Medical Software Systems Are Changing the Game

ipad ehrTo say that technology is evolving at lightening speed is truly an understatement. In fact, technology has evolved so rapidly that the world is a much different place than it was only 10 years ago. Not only has technology completely revolutionized the ways in which people live, work, and play, it’s also changed the way people heal.

Perhaps the most notable technological advances are those seen in the field of medicine. Not only are people living longer, healthier lives than ever before thanks to advances in both preventative and reactive medicine, but the quality of their lives has drastically improved, even if they are diagnosed with or suffer from a chronic illness.

In addition, technological advances have allowed health care providers to better treat their patients by providing better behind the scenes support and organization. Examples of this include streamlined practice management software, which also encompasses appointment software and electronic medical billing systems.

These highly advanced medical software systems allow physicians to maintain better patient records, which in turn expedites the process of evaluating and treating patients. Electronic medical records can improve a health care facility’s overall efficiency by 6% per year. In 2011, more than half — 55% — of physicians adopted electronic heath record (EHR) systems. Fast forward to 2013, and 78% of office based physicians were using some form of an EHR system, an 18% jump from 2001.

These critical systems have become so popular that there are several incentive programs for physicians who take advantage of them. Medicare and Medicaid EHR Incentive Programs provide payments to eligible medical professionals, hospitals, and critical access hospitals (CAHs) who adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology.

An example of this technology is the iPad EHR, which can be used in a variety of ways in a medical practice. The cloud technology offered by the iPad EHR allows medical staff and physicians to enter, store, and organize patient information and records with ease. As opposed to handwritten medical documents that can easily be misread due to illegible handwriting or are susceptible to deterioration over time, iPad EHRs provide medical practitioners with accurate, clear, and safely stored patient files.

5 Ways Medical Appointment Scheduling Software Benefits Both Practices and Patients

medical appointment scheduling

We spend most of our time on this blog discussing electronic medical records; that’s because web EMRs facilitate data collection both for individual patient records and for clinical and epidemiological studies, protect records from physical destruction, and improve overall efficiency by about 6% annually. But EMRs aren’t the only kind of medical software systems that can vastly improve a practice’s ability to run efficiently and profitably while serving its patients’ needs. Medical appointment scheduling systems, for example, can accomplish many of the same goals as EMRs. Here are five reasons you might consider a medical appointment scheduling software for your practice:

  1. Administrative Efficiency
    Appointment booking — as well as associated tasks such as rescheduling and appointment reminders — used to be up to office staff. But now, software can relieve that burden so staff can focus on other tasks. That means higher administrative efficiency and lower overall labor costs.

  3. Resource Allocation
    Complete scheduling software does more than help you keep track of when patients are coming in; it also helps you keep track of where your resources (doctors, nurses, open rooms, etc.) are going at any point in time. That makes it easy to ensure that your day-to-day clinical operations run as smoothly as possible.

  5. Patient Convenience
    Medical appointment software offers benefits to patients, as well as physicians and administrators. It’s no secret that Americans love doing things online, so your patients will be thrilled to book and view appointments on the web 24/7. This will also make it simple to choose from several available appointment times, making it easier for them to fit care into their busy schedules.

  7. Fewer No-Shows
    Appointment software makes it easy to set up appointment reminders via email or text, which translates into fewer missed appointments. That’s good for your patients, who get the care they need; good for your office staff, who spend less time on administrative work; and good for your bottom line.

  9. Easy System Integration
    Stand-alone appointment software offers all the above benefits, but an integrated software system is an even better choice because it ties appointments in with EMRs, medical billing software and general practice management software. That can make it easier to manage administrative and clinical actions from initial consultations all the way through financial claims.

Have you been considering medical appointment scheduling software for your practice? Discuss your needs and what’s been stopping you up to this point in the comments.

Should Electronic Medical Records Be Shared With Patients?

electronic medical records

Although electronic medical records can contribute to larger goals when it comes to epidemiology and public health, many of the arguments for using them come down to simple logistics: EMRs protect patient files from physical destruction, eliminate the concerns about legibility associated with handwritten records (which in turn can lead to medical errors), and result in an overall increase in efficiency of about 6% annually.

But online EMR software, in particular, offers another opportunity that’s far more controversial: sharing notes with patients, generally through secured online portals. Because so many patients ask for such access, and because so many healthcare providers express doubt about providing it, a recent research team decided to track what occurred when providers opened up their medical notes to patients.

The Outcomes
In order to measure the impact of opening up electronic medical records to patients, a team partnered with 105 primary care physicians at three sites. After a patient’s appointment, he or she received a message offering the opportunity to log on and read a note about the visit. Before the patient’s next visit, he or she received another message encouraging a review of the previous note in preparation.

The researchers found that more than 80% of the patients opened at least one note, and that more than two-thirds reported “better understanding of their health and medical conditions, taking better care of themselves, doing better with taking their medications, or feeling more in control of their care.” Very few patients (1% to 8%) expressed feeling worried or confused because of the notes.

The impact on doctors, though relatively minimal, also bears considering. Only 3% said they spent more time answering questions outside of regularly scheduled appointments (and email volume remained the same). About 20% of physicians said that being aware of patient access changed the ways they wrote about obesity, cancer, mental health and substance abuse, and about 11% said they spent more time writing and editing their notes. The full results of the study are available online in the British Medical Journal.

Patient Engagement
Of course, the issue should also be weighed with the big question of all EMR-related work in mind: Does sharing information with patients via web EMRs improve patient outcomes? The recent study’s authors suggest that it might. “Knowledgeable and actively engaged patients may have better outcomes,” a summary of the study’s conclusions reads.

Furthermore, allowing patients to access crucial information in a relaxed home setting — as opposed to the stressful, emotionally charged incidence of a doctor’s appointment or hospital visit — could allow patients to process that information better and become involved in their own healthcare in constructive ways. “We expect fully open records to foster truly collaborative patient-clinician relationships,” the study’s authors write.

Do you like the idea of sharing notes with patients through web based electronic medical records? Why or why not? Share your thoughts in the comments.

Survey Assesses Practitioner Satisfaction With Electronic Health Records

electronic health recordsThere’s no doubt that electronic health records and electronic medical records are becoming ubiquitous. These systematic, digital collections of health information regarding patients or populations are being adopted by a growing number of hospitals and office-based physicians in all specialties. Why? They standardize forms, terminology, abbreviations and input practices; facilitate data collection for epidemiological or clinical studies; and increase overall administrative efficiency. But here’s another question people often ask: Do doctors actually like using them?

According to the results of a survey conducted by Behavioral Healthcare and published Feb. 9, the vast majority of respondents who use electronic health records say that they’re satisfied with their medical software systems and put them to good use. “Overall, the top survey responses indicate that behavioral health professionals view EHRs as assets that improve patient care, which is clearly the goal,” the magazine wrote in its analysis of the survey results.

Just over 19% of the respondents said they were “very satisfied” with their current EHR system, 39% said they were “somewhat satisfied,” about 14% said their feelings were “neutral,” just short of 19% said they were “somewhat unsatisfied,” and just over 9% said they were “very unsatisfied.”

Reported Pros and Cons
The survey also broke down reasons for dissatisfaction, and these reasons may be enlightening for practices comparing various EHR systems, since the respondents used a variety of software bases. Ease of use was the clearest concern, with the top two disadvantages identified by respondents being that their systems were time-consuming (24.1%) and caused confusion (17.1%). Just over 16% of respondents found it difficult to generate data reports using their software.

On the plus side, only 1.7% thought that EHRs made billing and reimbursement difficult (many software options actually incorporate medical billing systems with EHRs so as to improve the collections process), and 17.5% said they experienced no disadvantages at all. One caveat to keep in mind is that many practices recognized that proper training often alleviated implementation problems.

And while administrative efficiency is often touted as a top benefit of using EHRs, the biggest reported benefit from users was that EHRs improved patient care (23.6%). Logistical advantages such as reduced paper storage (18.1%), staff efficiency (16.3%), improved income and reimbursement (14.2%) and help in tracking outcomes (11.1%) came after. Altogether, only 5.6% of respondents said their EHRs did not benefit their practices in any way.

Do the results of this survey give you a better idea of how electronic health records might help you in your practice, or what you might be looking for from medical software companies? Discuss in the comments.

Health IT News Roundup: Meaningful Use and Interoperability Roadmap

electronic health records

In just 24 hours at the end of January, the Department of Health and Human Services (HHS) issued two statements involving electronic health records that will impact both the physicians who use them and the medical software companies that develop the systems to support them. The first has a more immediate impact, while the other isn’t likely to affect physicians for some time. Here’s what you need to know to catch up:

Revision of Meaningful Use Standards
On Jan. 29, the Centers for Medicare and Medicare Services (CMS) announced on its official blog that it intends to create a new rule for reporting Stage 2 meaningful use in 2015.
Meaningful use means that EHR technology is being used to engage patients, improve care coordination, and improve the quality of health services, among other things. This is an important change because the Medicare and Medicaid Electronic Health Record Incentive Programs implement financial incentives and penalties for eligible physicians and hospitals if they implement or upgrade their electronic health records. In order to receive benefits, however, these healthcare providers must demonstrate what is called meaningful use.

Some physicians, it appears, have had no trouble making the changes to onsite or online EHR software systems to meet requirements. About 75% of physicians who had adopted an EHR system said that it met the federal criteria for meaningful use. But there was also quite a bit of feedback to CMS saying that providers would not be able to demonstrate meaningful use in time for 2015. So CMS will issue a new rule sometime this spring intended to ease reporting burdens for physicians and hospitals. This rule will be separate, CMS clarified, from the Stage 3 rule that should come out by March but won’t go into effect for another two years.

Roadmap for Interoperability in Health IT
The morning after CMS said it would revise meaningful use standards for 2015, HHS also released a roadmap from the Office of the National Coordinator for Health Information Technology (ONC) for achieving interoperability in health IT by 2024. At the core of this vision are electronic health records themselves, systematic collections of broad types of health data concerning both individual patients and populations (while it’s unnecessary to get into the EMR vs EHR issue here, you should know that many electronic medical records, while somewhat more limited, are part of those same goals).

The current draft of the roadmap has been dubbed version “1.0,” and is expected to evolve as various agencies and individuals weigh in. “It is only through everyone’s combined efforts that we will achieve a learning health system that brings real value to electronic health information as a means to better care, wiser spending and healthier people,” National Coordinator Karen B. DeSalvo wrote in the document’s introduction. The full roadmap is available on the website, and a public comment period will remain open until April 3.

Is there any other news about electronic health records you’d like explained? Ask questions or share your thoughts in the comments.

The 3 C’s That Matter When Choosing Practice Management Software

practice management software

Electronic health records (sometimes called electronic medical records) are clearly an integral part of healthcare now and moving into the future. These systematic collections of health information contain data not only about individual patients, replacing old-fashioned paper charts, but also help to synthesize data about entire populations in order to paint a clearer picture of public health needs. There has been a rapid adoption of EHRs in recent years. In 2001, only 18% of office-based physicians used an EHR of any kind; by 2013, that figure was 78%. Between 2012 and 2013 alone, the number of physicians using basic EHRs went up by 21%.

There are many reasons to use EHRs, among them that the integrated functions of practice management software can lead to both better patient outcomes and greater administrative efficiency. But how can you choose practice management software that offers the greatest possible number of benefits? Think of these three C’s:

  1. Competency
    If you’re looking at practice management software, your first concern should be that it’s adequate for whatever kind of practice you’re running. Some software solutions work for more than one kind of specialty, but very few work for all specialties. A cardiologist should look for a cardiology EMR, and a general practitioner should look for a family practice EHR. And even beyond these specialties, you should make sure the system offers enough customization to meet the needs of your individual practice.
  2. Completeness
    A basic EHR or EMR that replaces paper charts is helpful, but there’s no sense in implementing a new system without taking advantage of everything the latest technology has to offer. A truly complete practice management solution should address both clinical and administrative functions, and even integrate them; procedure codes, for example, can be tied to billing software so as to eliminate collections problems down the road. You can also tie in appointment scheduling and reminders or allow patients to view records through an online portal, helping them to get more involved and take more responsibility for their own health.
  3. Consistency
    All software has issues that need attention from time to time, but not all medical software companies offer the same level of service and support when problems arise. The developer of the software you choose should consistently be updating it to fit in with industry standards or legal requirements (as well as “meaningful use” criteria, assuming you’re taking advantage of financial incentives offered by the federal government), and offer you several ways to report bugs and reach out for quick help. Medicine is a fast-paced environment, and your technology service provider must be able to keep up.

What other criteria must medical practice software fulfill? Discuss in the comments.

Stage 3 of ‘Meaningful Use’ Guidelines for Electronic Medical Records Now Under Review

electronic medical recordsElectronic medical records and electronic health records (look at some of our past entries for an explanation of the distinctions) are quickly becoming ubiquitous in the medical field. Part of this is simply a matter of convenience for practices, particularly since EMRs can be integrated with medical appointment software and medical billing systems.

But part of this growing popularity also has to do with government incentives set in place to encourage adoption of EMRs and EHRs; as of 2013, 69% of physicians said they intended to participate in or had already applied for the Medicare or Medicaid Incentive Programs. However, there has always been some difficulty determining what electronic medical records should be able to do in order to qualify for these programs.

The Office of the National Coordinator has an EHR certification process that ensures functionality and the ability of software to meet specific objectives. But the guidelines that have caused the most consternation are the “meaningful use” guidelines physicians must meet in order to receive financial benefits. There are indications that things are getting better. Between 2010 (the earliest year for which data is available) and 2013, adoption of EHRs able to support Stage 2 of meaningful use as defined by the government increased significantly. But now, Stage 3 meaningful use criteria are being debated.

Proposed Changes for Stage 3
It was reported in mid-January that the Office of Management and Budget had received proposed changes to the Stage 3 rules. Basically, the proposal would relax the all-or-nothing tone that permeated the Stage 2 rules. Many small practices, in particular, had felt that these requirements were Draconian and better suited to large health organizations. The proposed guidelines would also make reporting periods, timelines and structures more flexible. It has also been reported that the OMB wants to create a single definition for the concept of “meaningful use.”

In general, these are good signs that the current administration may ease the burden on physicians, especially those in small practices who have fewer resources to devote to administrative tasks. But there’s still some skepticism regarding whether these new deliberations will resolve all concerns. As Anne Zieger commented for HealthcareDive, “Making rules to define other rules so you can come up with a plan to maybe get something done by 2017 (when Stage 3 is supposed to kick in) doesn’t sound like a winning strategy for an industry that is fighting crises on multiple fronts. Let’s hope regulators get it right this time around.”

Do you have any insight regarding meaningful use of electronic medical records, or questions regarding medical software systems? Join the discussion in the comments.

How Electronic Health Records Identify Treatment Problems and Support Solutions

electronic health records

There are numerous benefits to using electronic health records or electronic medical records, and it’s easy to list them abstractly: EMR practice management software protects against physical file destruction, standardizes terms and abbreviations and simplifies data input, and increases efficiency for healthcare providers by about 6% annually. It’s clear that using electronic records has significant administrative benefits.

But electronic records also support better patient care. Sometimes, this is because digital records can automatically check for negative drug interactions, or notify doctors of allergies. But on a greater scale, digital data collection and sharing makes it possible to identify worrisome treatment trends and work to reverse them. A recently reported example demonstrates the usefulness of electronic records in this capacity:

Unnecessary Hysterectomies Common in Michigan Hospitals
Data collected from 52 Michigan hospitals by the Michigan Surgical Quality Collaborative has shown that nearly one in five hysterectomies performed in 2013 in response to benign indications was unnecessary, Family Practice News reported Jan. 10. The review showed that 18% of the 3,397 hysterectomies that were reviewed did not need to be performed according to uterine pathology reports. For women under 40 years old, that number rose to 38%.

According to their medical records, nearly 50% of the women never underwent (or even were counseled on the possibility of) other treatment routes to avoid surgery. These would include hormone management, operative hysteroscopy, endometrial ablation and intrauterine devices (better known as IUDs). These methods were documented for 68% of women under 40, but were far less likely to be tried for women over 40.

Electronic Health Records Part of the Solution
The researchers on the project say that a simple checklist assessing the appropriateness of surgical intervention could significantly reduce the rate of unnecessary hysterectomies. Previous studies have shown that when such checklists are used, it is far more likely that pathology, too, will support operations.

Electronic records can, therefore, not only reveal treatment trends, but also aid in modifying them. The report released by the collaborative notes both that these checklists “could help standardize treatment and ensure appropriate uterine-sparing management has been offered,” and that “the use of electronic medical records systems could potentially facilitate this type of standardization with relative ease.”

Can you think of any other specific examples of how electronic health records can lead to more effective and lower risk patient interventions? Join the discussion in the comments.

Meeting the Security Challenges Posed by Web Based Electronic Medical Records

web based electronic medical records

The use of electronic health records is growing, and that’s a good thing for patients and practices alike. Electronic medical records can increase the efficiency of healthcare providers by 6% annually; digitizing forms makes it easier to collect data for clinical studies or epidemiological purposes, leading to better public health policy; and eliminating handwritten records can reduce avoidable errors associated with poor legibility and incomplete record-keeping. In this day and age, transitioning to EHR software is a question of when, and not if.

However, there’s one important topic any physician considering the implementation of web based electronic medical records needs to stay abreast of: security. Experian’s 2015 Data Breach Industry Forecast identifies healthcare data breaches as an area of significant concern for the upcoming year.

The Cyber Dangers
“The expanding number of access points to Protected Health Information (PHI) and other sensitive data via electronic medical records and the growing popularity of wearable technology makes the healthcare industry a vulnerable and attractive target for cybercriminals,” reads the Experian report. The healthcare industry does not protect itself as well as the financial or retail sectors, perhaps because of a perception that medical information is not as valuable as the kind of data stored by financial institutions. But medical information can be used for a wide variety of frauds. Furthermore, because of the rising popularity of web based electronic medical records that give some access to patients, criminals can gain entry through those routes, which are likely to be less heavily protected.

As even the report itself notes, concerns over patient privacy have only been exacerbated, and not created, by the movement away from paper records. Medicare cards, for example, bear valuable information such as a patient’s social security number — and these cards are often carried around in patient’s wallets. Thus, securing data will require not only technical measures, but also a better public education regarding what information is likely to be sought by criminals.

What You Can Do
The best move you can make, of course, is choosing products from medical software companies with a good background in security. You don’t want your online EHR software itself to be the weak point. Before you purchase any software, get information from its creators about its security features, and ensure that there’s a strong customer support system in place in case you have ongoing questions.

Second, you’ll want to secure your own facilities and devices so that you’re not giving access to cybercriminals. Experian warns that “Healthcare organizations will need to step up their security posture and data breach preparedness” in the coming year. If you’re using software that includes a patient portal, be proactive in helping your patients understand the privacy measures they can take, too, including choosing strong passwords and only accessing the portal through secure connections.

Are you using web based electronic medical records? What steps are you taking in your practice to ensure electronic records don’t put your patients’ private data at risk? Discuss in the comments.

EMR Vs EHR: What’s the Difference?

electronic health recordsIf you’re researching the electronic records kept by healthcare providers, there are two terms that are likely to come up: electronic health records and electronic medical records. What’s this EMR vs EHR issue? Here’s some information that can help you make sense of what you’re reading:

The General Idea
In casual conversation, you’ll likely hear the terms EMR and EHR used interchangeably. Both refer to the idea of moving the information that once would have been kept in paper files into software applications, kept either online or on a central computer. Both also have the goal of increasing administrative efficiency (by helping to standardize forms and reduce data input), protecting files from physical destruction (through office fires or floods), and keeping important data safe and private (through advanced security systems including permissions for viewers).

It’s also been shown that electronic records improve patient care. Doctors can make better decisions when they can easily access all a patient’s information. Web based electronic medical records that have user interfaces for patients can also get patients more involved in their own care.

Drawing Distinctions
There are situations, however, in which it’s helpful to draw a finer line between electronic medical and electronic health records. The Office of the National Coordinator for Health Information Technology, for example, uses only the term electronic health records. Why? EMR software, in its narrowest sense, is purely medical, taking what would be on a doctor’s chart and digitizing it. It’s mostly a tool for diagnosis.

EHR systems, on the other hand, emphasize a broader concept of “health” as wellbeing of the body and mind. Both EMRs and EHRs will monitor data over time, keep track of when patients are due for checkups, and record vaccinations and important indicators like blood pressure. But an EHR system is intended for collaborating outside an individual practice, both with the patient and other practitioners.

Which Do You Need?
The scope of the medical software systems you choose will be based on your practice, of course. Collaborative, web based software seems to be the way of the future though, so it may be a wise investment now. The other thing to keep in mind if you want to benefit from the financial incentives the federal government has put in place for using electronic records is that any software you choose should meet the “meaningful use” criteria put in place by the incentive programs.

What are you looking for in an electronic record software system? Discuss or ask questions in the comments.

Survey Shows Patients Approve of Electronic Health Records, Want Online Access

medical billing system

Medical practices of all sizes have seen that electronic health and medical billing system software can benefit care providers by improving day-to-day efficiency and streamlining collection (by automatically linking care records to medical billing systems, it’s easier to submit claims and receive payment from insurance companies). The shift toward electronic health records may have been precipitated by government-provided financial incentives — and indeed, as of 2013, 69% of physicians said they were participating in or intended to apply for the Medicare and Medicaid EHR Incentive Programs — but their use is becoming entrenched because they work well.

Patient Perceptions
But how do patients feel about their electronic medical records? According to a new report put out by the National Partnership for Women and Families, patients too find “significant” value in electronic records and want to have more personal access to them.

The report is based on a Harris Poll survey conducted last spring. Of the 2,000 participants, more viewed EHRs positively in 2014 than viewed them positively in 2011. Between 85% and 96% of respondents said that EHRs benefited both providers and patients — a number that was between only 57% and 68% for paper records. That outlook remained the same even if the respondent’s own doctor wasn’t currently using EMR software.

The report suggests that one reason for this is the growing ubiquity of EHRs. In 2001, only 18% of office-based physicians used EHRs of any kind. A decade later, that figure rose to 55%. Last year, 78% of physicians had adopted an EHR system.

Patient Concerns
Both positive and negative patient feelings about electronic records seem to be linked to interconnected concerns of accessibility and privacy. Of the survey respondents, the number who had access to their information via online EMRs had almost doubled in three years alone (jumping from 26% to 50%). Among patients who had that capability, 86% took advantage of their access at least once annually. And here’s an important takeaway: Patients with access to their records via the Internet have higher overall trust in the value of EHRs.

But accessibility can also lead to questions about security and privacy, and that still seems to be the biggest battle EHR proponents face in terms of public perception. A different study, conducted by the Office of the National Coordinator for Health IT, found that 75% of the patients surveyed with either “very” or “somewhat” concerned about the privacy of their medical records. Ameliorating those doubts is the next step for the industry.

Do you have any recommendations on how doctors and the makers of electronic health and medical billing system software can provide patients better access while alleviating their privacy concerns? Join the discussion in the comments.

How Medical Software Can Contribute to Public Health

medical software companies

By now, it’s well known that electronic health records can both improve patient care and increase efficiency in medical practices. The first goal is served by putting relevant medical information at doctors’ fingertips and supporting the best possible care decisions, as well as utilizing medical software systems’ ability to automatically check for negative interactions between prescribed medications. The second is achieved by reducing the logistical and administrative burdens placed on doctors and office staff; electronic records standardize forms and data input, leading to a 6% overall increase in annual efficiency.

But the Institute of Medicine is suggesting that medical software companies can play a role in promoting public health by helping doctors to record certain social and behavioral information. It’s already been established that electronic medical records facilitate data collection for use in epidemiology and clinical studies. And now, the IOM has released a list of 12 factors it believes all medical software companies and doctors should record in electronic records.

Two-Phase Project
The IOM committee charged with selecting the factors, led by co-chairs Nancy Adler of the University of California San Francisco and William Stead of Vanderbilt University, has been working since 2013 on a two-phase project. Their first goal was to identify the social and behavioral characteristics that are most strongly correlated with health; their second was to identify which of those could be effectively recorded in EHRs.

The committee also hopes that the positive outcomes of their work will be twofold. On one level, these additional factors can support the improvements in patient care that have already been associated with EHRs. Doctors will be able to take into account broad social factors that impact the health of various segments of the population. But overarching that goal is the desire to collect data that can point to how disease develops and whom it affects.

Top Factors
So what factors does the IOM recommend recording? Providers should use EMR software to capture some census information (race, ethnicity, address, community composition), but also to dive more deeply into lifestyle decisions (tobacco and alcohol use, levels of physical activity) and mental health (educational levels, depression, stress, financial worries and exposure to violence). The full list, along with detailed explanation, is available in the report, titled “Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2.”

Doctors, have you talked to your medical software companies about how to best record this type of information? Patients, would you feel comfortable having this information recorded by your doctor? Join the discussion in the comments.

5 Reasons Electronic Medical Records Benefit Both Doctors and Patients

Electronic medical records are fast becoming standard. As of last year, 78% of office-based physicians used some type of EMR software; that’s up from only 18% in 2001. Part of that change is probably due to the Medicare and Medicaid Electronic Health Care Record (EHR) Incentive Programs, which provide monetary incentives for certain kinds of implementation. But the other reason is simply that physicians are seeing the many benefits electronic health records offer both doctors and patients. Here are five to consider:

  1. Better Patient Care
    Having a patient’s information at their fingertips at all times (and on multiple devices, with web based electronic medical records) allows doctors to make more accurate diagnoses and better care recommendations. EMRs can also reduce errors, whether they’re due to a lack of information or the messy handwriting that plagues nearly all handwritten records. Electronic records even keep track of prescriptions and allergies and automatically alert doctors as to potential negative interactions.
  2. Healthcare Provider Cooperation
    Electronic records allow various healthcare providers to collaborate, both inside and outside a practice. Nurses, doctors and lab techs can easily share information gathered across visits. And the benefits don’t stop at an individual practice’s doors: an emergency room doctor, for example, could pull up a patient’s electronic record and learn of a serious long-term condition even if that patient were in a coma. There are extensive security measures encoded in EMR software to ensure that only qualified people with the correct permissions can view files, so there’s no increased risk.
  3. Clinical Data Collection
    Standardizing and digitizing records allows for much better data collection to be used in epidemiology and research. This in turn can lead to more evidence-based policy decisions and more effective treatments, benefiting national (and in some cases global) health.
  4. Increased Efficiency
    Electronic records streamline the system through features like e-prescribing and lab result sharing. In fact, it’s been shown that EHR systems can lead to a 6% annual increase in efficiency. That efficiency leads to cost savings for practices. Patients can also see decreased costs because providers are less likely to re-order tests that have been performed elsewhere.
  5. EMR Practice Management
    Complete EMR practice management software can do more than track patient information. It can be integrated with medical billing systems and appointment software, cutting down on office labor costs and ensuring smooth and well-documented payment handling. And best of all, reducing these administrative tasks frees up more time for doctors to actually spend tending to patients or adding to their medical knowledge.

What are some other reasons to consider complete EMR practice management systems? Add your thoughts in the comments.

3 Ways Electronic Health Records Support Better Patient Care

Electronic health records will save the global health industry $78 billion over the next five years, according to a new study conducted by Juniper Research. “Advanced EHRs will provide the ‘glue’ to bring together the devices, stakeholders and medical records in the future connected healthcare environment,” said Anthony Cox, the report’s author and an associate analyst at Juniper.

This is just one more indication of what has been clear for several years now: Electronic medical records are an integral part of the near future’s healthcare climate. As of last year, 78% of office-based doctors used an EHR system; in 2001, that figure was only 18%. In fact, the adoption rate went up by 21% between 2012 and 2013 alone.

It’s proven that EMR practice management can save physicians money. But one of the biggest controversies regarding electronic medical records is whether they can actually improve quality of care. Here are three ways that they can:

  1. Fewer Distractions
    Any time physicians spend on the logistical aspects of running a practice is time they can’t spend with their patients or on keeping up with the latest medical advancements. EMR software can be integrated with medical billing systems and even appointment software so that doctors can make patient care their primary concern. It’s been shown that EHR systems improve annual efficiency by about 6%.
  2. Better Data Collection
    Electronic health records allow for complete data collection and instantaneous access from a variety of devices. It also standardizes formats for better data comparison and general ease of access. Having as much information as possible — in a form that’s as convenient as possible to access — supports better patient care by allowing doctors to quickly make informed decisions.
  3. Error Reduction
    There are two factors at play here. First of all, electronic health records reduce the legibility problems that so often plague handwritten files. And second, EHRs can generate automatic reminders and alerts. For example, EMR software might check that none of the drugs prescribed to a patient have documented negative interactions, or an emergency room doctor could pull up a patient’s EHR and see that her primary care physician had previously noted a dangerous drug allergy. These abilities can save patients’ lives.

Of course, even once it’s been demonstrated that electronic health records can lead to better patient care, there are a few things to keep in mind. Staff need to have adequate training on any new system if it is to increase efficiency, and electronic records will never replace communication between doctors, nurses and other healthcare providers.

Do you have any other questions about how electronic health records can benefit your practice? Join the discussion in the comments.

The 5 Criteria That Add Up to a Winning Electronic Health Record System

ipad ehrThere’s no doubt about it: Use of electronic health records is on the rise. The number of physicians with at least a basic EHR system in place grew by 21% between 2012 and last year alone, and nearly 50% of physicians not currently using one plan to purchase one or implement use of a previously purchased software within a year. But what should you consider if you’re still shopping around for an EHR system that can bring your practice up to date? Here are the five most important things to keep in mind:

  1. Meaningful Use Compliance
    One of the reasons EHR use has grown so rapidly is because of the financial subsidies offered by The Medicare and Medicaid Electronic Health Care Record Incentive Programs for medical facilities that can demonstrate “meaningful use” of electronic medical records. There’s been quite a bit of confusion — and flux — over what the government requires in terms of meaningful use, so you’ll want to work with a software company who is staying on top of all the changes.
  2. Ease of Use
    Electronic records can allow for better data management and patient care, but only if they’re easy to use. There’s always a learning curve when you’re adjusting to new software, but you should be putting more focus on your patients than on figuring out what’s happening on your screen.
  3. Device Accessibility
    One of the primary benefits of web based electronic medical records is the ability to access them from multiple devices. Look for smartphone or iPad EHR apps, in addition to something that will work on a desktop.
  4. Security and Privacy
    Especially if you’re looking at smartphone and iPad EHR apps, it’s vital that you’re choosing something that’s secure and HIPAA compliant. Your vigilance should be amplified if you and the other professionals in your practice will be using your own electronics for both work and personal purposes (a practice referred to as BYOD — bring your own device). Make sure your system allows you to set certain permissions to prevent unauthorized viewers from accessing files.
  5. Feature Integration
    Keep in mind that some EHR systems can do more than track patient care. Choosing a system that communicates with medical billing systems or appointment software can further increase efficiency in your practice.

In addition to all these criteria for the software itself, you should also make sure you’re purchasing from a company who offers ongoing updates and support for its software. Getting started on a new system can be tricky, and you’ll have a lot more peace of mind knowing that there’s someone you can call for help.

Healthcare providers, do you agree with this list? Patients, how do you feel about doctors using smartphone and iPad EHR when treating you? Add your thoughts in the comments.

Without Training, Staff Can’t Properly Use Electronic Health Records Software

/>Both electronic health records and their more succinct cousins, electronic medical records, are a huge boon to the medical and health care industries. They help standardize forms, terminology, abbreviations, and data input. What’s more, online EHR and online EMR software can also improve a medical facility’s overall efficiency by about 6% per year.

So it’s more than a little surprising that, according to a 2014 survey of the American College of Physicians, family practice physicians spent 48 minutes more a day when they used EMRs. Even stranger, the Medscape Electronic Health Records Report 2014 also found that doctors thought the software decreased the amount of time they could spend with patients.

If electronic health records and electronic medical records can make a practice all the more efficient, why then are they eating up so much time?

Simple — because medical professionals aren’t being trained to use their facilities’ electronic health records software properly. According to the Medscape Electronic Health Records Report 2014, 70% of doctors claim that they lost face-to-face time with patients as a result of having to figure out a new system.

Once properly trained, health care practitioners will find that electronic health records can improve the quality of care they offer, make things more efficient, and even help them screen patients better.

After switching from paper to EHR, nurses reported in one survey that they saw a reduction in the time it takes to properly document patients by up to 45 percent.

What’s more, according to a 2013 study published in the Journal of General Internal Medicine, EHR software was associated with significantly higher quality of care for patients with diabetes, breast cancer screening, chlamydia screening, and colorectal cancer screening.

There’s no doubt that EHR and EMR software can improve a medical facility’s operations, but in order to do so, staff must properly trained. Otherwise, the programs may wind up hurting more than helping.

If you have any questions, feel free to ask in the comments.

AMA Calls for Revision of ‘Meaningful Use’ Criteria in Electronic Record Incentive Programs

The Medicare and Medicaid Electronic Health Care Record (EHR) Incentive Programs provide financial support to eligible medical practices and hospitals who are upgrading or implementing EHR systems as long as they meet standards of “meaningful use.” The current criteria for meaningful use, however, are frustrating some medical professionals.

On Oct. 14, the American Medical Association released a suggested reworking of meaningful use guidelines to the Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health Information Technology. AMA President Robert M. Wah said that doctors want to see guidelines that will actually improve patient care.

“Physicians will always embrace technology that can help them provide better care for their patients and foster innovation, but improvements must be made to the meaningful use program in order for those goals to be achieved,” he said in a statement.

Suggested revisions include the following:

  • A more flexible approach that will allow a broader spectrum of physicians to participate
  • A reduced reporting burden on physicians
  • An evidence-based approach that puts patient care at the forefront
  • A focus on interoperability, or the ability for different systems to work together

The AMA asked the offices overseeing these programs to soften the current “all-or-nothing” approach, allowing those who meet 50% of program requirements to avoid penalties and those who meet 75% to receive incentives. The group also said that any criteria that a “vast majority” of doctors have been unable to implement should be made optional, and that hardship exemptions should be expanded.

What Practices Can Do
What does this debate mean for smaller practices attempting to comply with federal mandates? Approximately 75% of doctors using EHR systems report that they meet meaningful use requirements. Regardless of potential changes to incentive programs, electronic medical records that, at minimum, store patient information are fast becoming the norm; as of last year, 78% of office-based physicians used in-house or online EMR software, as opposed to only 18% in 2001. There are two important steps to take while policy is in flux:

  • Stay on Top of the News: It can be more difficult for smaller practices to keep an eye or current rulings than it is for large hospitals with teams of lawyers and doctors dedicated to tracking policy changes. But it’s worth putting some time and resources into this effort, since misunderstandings can result in penalties and/or forfeited financial assistance. There have already been numerous revisions and extensions regarding EMR software implementation requirements, so it’s likely things will change again.
  • Make a Good Long-Term Choice: The first step is to ensure that any EMR software you choose is certified for Stage II of meaningful use as currently defined. But you can also be forward thinking, choosing online EMR software that allows you access patient data, look up ICD codes and auto feed billing.

It’s also a good idea to choose medical software companies that provide ongoing support, since there may be updates over time.

Do you use an online EMR software in your current practice? Do you think it’s actually increased the quality of patient care? Share you opinion in the comments section.

Will Every American Soon Have an Electronic Health Record?

medical software companiesHealth information technology has been a priority for the past two presidents, with both George Bush and Barack Obama setting 2014 as the goal year by which all Americans should have electronic medical records. Medical software companies have developed a variety of options for hospitals and private practices of all sizes, and the Medicare and Medicaid Electronic Health Care Record (EHR) Incentive Programs, which were created to provide funds for implementing and upgrading electronic record systems for eligible hospitals and practices, have further spurred adoption.

Missed Goals Amid Gains
But as 2014 is rapidly drawing to a close, have the ambitious goals set by Bush (in 2004) and Obama (in 2009) been met? Not quite, Nextgov reported as of Oct. 9. About 75% of eligible clinicians and 91% of hospitals who treat under Medicare and Medicaid have implemented EHR systems, according to Jodi Daniel, director of the Office of Policy in the Office of the National Coordinator for Health Information Technology.

However, these percentages may not indicate how close America is to realizing the vision of universal electronic health records. There is no way to determine what percentage of the patients who are treated by Centers for Medicare and Medicaid Services providers actually have EMRs. CMS provides care for about a third of the U.S. population, but those numbers are further complicated by the fact that those same providers also treat non-CMS patients. This led Daniel to estimate that “a significantly larger number” of Americans have EHRs than can be demonstrated through CMS metrics.

There’s also no way for Daniel’s office to estimate how many non-CMS providers have implemented EHR systems outside the purview of the incentive programs.

Reasons to Participate
If your practice has been looking at medical software companies in anticipation of implementing an EHR system, there are several reasons to make the change from hard-copy records as quickly as possible:

  • Reduced Possibility of Misunderstanding: Jokes about doctors’ handwriting aside, it’s far easier to miss a hand-scrawled note than an electronic one.

  • File Protection: Electronic records are far less vulnerable to destruction than physical ones.

  • Increased Efficiency: It’s been shown that EMR systems lead to a 6% annual increase in efficiency.

EMRs are becoming more common among office-based physicians, with adoption rising 21% between 2012 and 2013 (the most recent data available). It’s becoming clear that EMR software is the inevitable path for the future, so it’s worth embracing the change — choosing the right system for your practice in order to ease the transition — for the sake of medical staff and patients alike.

Do you use electronic health records in your practice? What do you think makes some medical software companies better than others to work with? Share your perspective in the comments.

Are you ready for ICD-10?

Benchmark Systems Practice Management System is. 

Hopefully, by now your office has started thinking about the implementation of the International Classification of Disease codes, revision 10(ICD-10).  This classification of diseases and related health issues is supported and promoted by the World Health Organization(WHO).   Many countries around the world have already started using this latest classification.  In fact, countries like Australia and Sweden have been using this latest revision since the late 1990’s.

Now, it is time for the United States to jump on board.  CMS has determined that all practices and insurances companies start communicating using the ICD-10 format starting on October 1st of 2014.  But, it is never too early to start getting your practice prepared for the change.  Software companies, insurance providers and electronic clearinghouses are already in the process of testing and preparing their software and connections for this change.

In fact Benchmark Systems Practice Management software has just released the latest version of their software that fully supports upgrading your practice to, and the ongoing usage of the ICD-10 code set. 


What does this mean for you?

As a practice you need to first become familiar with the new ICD-10 code set.

The code set allows more than 14,400 different codes and permits the tracking of many new diagnoses. The codes can be expanded to over 16,000 codes by using optional sub-classifications.  The basic structure of the ICD-10 code is the following: Characters 1-3 (the category of disease); 4 (etiology of disease); 5 (body part affected), 6 (severity of illness) and 7 (placeholder for extension of the code to increase specificity).  In general  what this means for your practice is that a specific code that you might have used in the ICD-9 code set will usually translate to multiple codes representing the same disease, but allow for more specific and detailed identification.  It is highly recommended that your practice staff become familiar with the new code set.  There are several resources you can access to help you with this process. Access the WHO web site for several online training resources and additional information about ICD-10 (  CMS also has online resources to assist you with your transition to ICD-10 (  There are also free online ICD books that will help you with the transition to ICD10. is a site that allow you to search for and see information about an ICD-9 code. It also provides a link to the corresponding ICD-10 code(s) on the site

As a practice you need to evaluate the readiness of your current practice management and billing software to handle the change to ICD-10.

Check out your software companies web site and contact their support department to determine what they have done and are doing to ensure their software is ready to help you transition to and support ICD-10.  If you have concerns about their readiness, start a search as soon as possible for software the will be able to support this new code set.

As a practice you need to determine a cut-over date for when you will start using ICD-10.

Once this date is determined, start using ICD-10 and don’t look back.  Depending on the process your software system allows, it would be best if you could start using the ICD-10 codes prior to the 10/1/2014 deadline.  This will help ensure there is no interruption of cash flow once we reach the deadline.   Now, it is true that many insurance companies will not accept the new codes until the deadline is reached.  But, if your software system is developed with the practices best interest in mind, it will have ways for you to start using ICD-10 and make the appropriate accommodation  to send the correct code ICD-9 or ICD-10.

As a practice you need to continue to monitor the readiness of all parties participating in your financial workflow.

You should continue to monitor your software systems web site, insurance company web site, clearinghouse web site and any announcements from CMS that pertain to ICD-10.  As you may be aware the deadline for usage of ICD-10 has already been extended once.  It is possible for this to happen again.  So, continue to monitor the situation to keep yourself informed.

A year from now, I hope we will all look back at this transition and think “what was the big deal?”  Then we can all move forward with using the latest code set that allows for much more clarity in identification of diseases, not to mention catching up with the rest of the world.  But, being prepared and informed as a practice will get us all closer to making my hopes a reality.

Meeting Meaningful Use

As you probably know by now, Medicare & Medicaid EHR Stimulus programs provide incentive payments to physicians if they can qualify for the Meaningful Use of a certified EHR technology.  Over 350,000 eligible physicians have registered with Medicare and Medicare for stimulus payments and over 3.7 billion dollars have been paid out since 2011.  In 2013, physicians can still get up to $39,000, payable over four years.  But if they decide to wait another year, the payment drops down to $24,000 in 2014 payable over three years.  Starting in 2015, there are no more payments. Practices that have chosen to remain on a paper system have and will continue to be penalized in their Medicare and Medicaid payment checks.

There is another side to the Stimulus program. Many providers who purchased EHR software are not qualifying for Meaningful Use. As per the latest CDC study only 27%. The reason lies in the fact that although certified, most EHR’s won’t attest for the basic requirements of Phase 1 or Phase 2, which is more difficult.

To qualify for Stage 1 of Meaningful Use, eligible physicians must meet all 15 of the Stage 1 core objectives and 5 of 10 menu set objectives using certified EHR software. The reporting period for the first year is any 90 continuous days during the calendar year.  In order to meet Meaningful Use, EHR software must provide the specific fields needed to capture data and measure outcomes.  If any required data is missing because it can’t be or was not captured, Stimulus funds will not be paid.

The selection of an EHR is one of the most important decisions a practice will make.  The goal is to not only choose the correct software but the company behind it. Free and inexpensive solutions are usually too good to be true. The right company will provide the training, implementation, support, and help to pass attestation.

Many physicians now find themselves working with EHR software that is certified but has not been able to qualify for Meaningful Use! If you’re one of these physicians, it is not too late! There is still time to change to an EHR that will meet your needs and qualify you for at least $39,000 of Meaningful Use.

If you are in the search for the right EHR, this is your first and final chance to get it right.  Consider if the software vendor has references that have already met Stage 1 of Meaningful Use.  Here at Benchmark, we guarantee our EHR will qualify or we will pay the Stimulus dollars! If you go with Benchmark, you get paid either way.

Jacques Kreisler

Benchmark’s Reputation as Observed by Employees and Customers

I was hired about a month and a half ago as Benchmark’s new Marketing Intern. I am currently in my last semester at Liberty University earning my undergraduate degree. Before applying at Benchmark, I had no experience in healthcare apart from my yearly doctor’s office visits and my mom’s opinions as an experienced RN. My initial weeks here at Benchmark included a whirlwind of new information that I had no idea existed! The concepts of practice management systems, and electronic health records were completely foreign to me.

One of the first tasks I was given while working at Benchmark included gauging customer satisfaction in relation to the products that they have purchased. With a new and unbiased point of view without any prior knowledge about the software or healthcare industry, I was able to listen to customers and learn about Benchmark Systems from their point of view.

I learned that although Electronic Health Records and Practice Management systems seem complicated, the Benchmark employees and support have made it easy for customers to understand!

While interviewing the different clients, I was pleasantly surprised to find that the majority of the feedback was positive and true to what I have observed of Benchmark employees while working here. Many different phrases shared by the practices I interviewed included that Benchmark Systems provides solutions that are user-friendly, organized, and easy to train with. Many also said that the employees at Benchmark are supportive and very quick to respond because of their expertise in the specific systems.

During my interviews I asked the managers what their recommendations would be to others looking into purchasing a Clinical EHR or Practice Management System. Here are some of their responses:

Beth from New Market Medical Center stated,
“Benchmark is user-friendly and anybody who is not computer savvy can use it!”

Michelle from Houshang Makipour, MD stated that,
“From my experience working with other EMR’s in the past, Benchmark is by far the most user-friendly! It is the best quality EMR because although employees come and go, Benchmark transitions between those times.”

Diane from Kenneth Holling, MD stated,
“Support is awesome! Whenever I have a problem, a Benchmark employee always calls me back right away! The system is always user-friendly!”

Benchmark Systems is here to meet your practice’s needs and is eager to help you as much as possible!

Jaime Skilling
Marketing Intern
Benchmark Systems, Inc.

Most Doctors are not able to Qualify for Meaningful Use with their Certified EHR

While it had good intentions, EHR Certification has turned into a worthless list of 3,000+ products that could, may or probably will not pass accreditation for Stimulus funds. This has given physicians all over the country a false sense of security in selecting the proper EHR for their practice. This is not my opinion, this is a FACT. Let me document with independent studies from very respectable sources:

According to the most recent CDC study; in 2012, 27% of office-based physicians who planned to apply or already had applied for meaningful use incentives had computerized systems with capabilities to support 13, the bare basic requirements, of the Stage 1 Core Set objectives for meaningful use. For the full report visit

Other studies support similar findings:

A study published in Health Affairs finds that while 91 percent of physicians were eligible for Medicare Meaningful Use programs, only 11 percent of those intending to apply are in a position to take advantage of this incentive. This is irrespective of what kind of EHR they use; web based EMR or client server EMR. Drilling down a bit more, the study says only 11 percent of those intending to apply had enough EHR capabilities to support up to two-thirds of Medicare’s Stage 1 core objectives. This means their EMR system does not have the necessary capabilities.

“During 2011, the first year of the incentive programs, almost 124,000 eligible professionals, including physicians, had registered for Medicare incentives, and the Centers for Medicare and Medicaid Services had paid nearly $275 million to 15,000 participants,” study authors say. “Medicaid meaningful use incentives, which flow through states, totaled about $220 million and went to approximately 10,500 physicians.”

Those EHR/EMRs that seem too good to be true (ex. system is marketed as being free or a couple of thousand dollars up front with a few hundred dollars a month) are costing physicians the ability to get reimbursed for installing a real EHR. A large amount of money is being lost equaling $44,000 in 2012, $39,000 this year, and next year the reimbursement drops to $24,000! That is not even taking into consideration the penalties that will be assessed to a practice for noncompliance.

We stand behind our product and guarantee every dollar… Phase 1 and Phase 2.
Our guarantee is simple and to the point:

Eligible professionals who utilize  Benchmark Clinical EHR technology toward Meaningful Use certification, but do not achieve federal funding because of a failure of the Benchmark Clinical EHR product to meet Meaningful Use certification , will be compensated equal to the amount of lost stimulus funds that would have been paid during the Benchmark Clinical EHR compliance failure.

Who would you rather do business with?

Ernie Chastain
Vice President
Benchmark Systems, Inc.

A Professionals View of Training

I have seen two models – one where a vendor does not charge any ‘upfront’ fee, and another is where a vendor charges an upfront fee for training but their monthly fee is lower. Which one is better?

Before we look into “which one is better”, I’d like to talk about the fundamental differences in approaching Training that has a profound effect on how training is imparted.

Training works best if…

The Vendor and your Practice work in the spirit of ‘Partnership’ rather than an adversarial ‘client/customer/supplier’ relationship.

What does this mean? How do you determine whether or not a relationship is a true ‘Partnership’?

A good partnership begins with the first call to your web based software system supplier (prospective partner). Here are some examples of indicators:

  • When you call and leave a message, how are you treated? How soon is your call returned?
  • Does the company attempt to answer your questions, ask you about your concerns or just try to sell you their system?
  • Do you answer their questions in a professional manner? Do you return the sales person’s calls? If no, why not?
  • Do you show up on time for online demos and meetings? If no, why not? Don’t some practices charge patients for ‘no-shows’? So, let’s treat each other equally.
  • When trainers are there in your office or online, do you spare time for them and really give them full attention?
  • Does the Company support staff give you their best attention and care as you would to your patient?

No Upfront Fee model

If there is no upfront fee involved, a business tends to look at Training as a ‘cost center’ – an expense that a company has to deal with. We know that financial accountants and business owners try to minimize expenses. By direct implication, they cut corners. The quality of training tends to suffer. There is a general lack of ‘incentive’ for the management as well as employees since there is no ‘accountability’.

As they say, there is no free lunch. In spite of the ‘no upfront’ fee label, guess what, you’re paying for it- financially by raising the monthly fee or in terms of quality.

What I fail to understand is why do providers fall for this?

In fact, I venture to say that Training and implementation is more important than the software system itself. A bold statement, yes, but I want to stress on the importance of not compromising Training, because Quality and Quantity are both important.

Upfront Training Fee model

I urge you to look into this model because of two very simple reasons.

  1. The company is accountable and responsible for doing adequate training within a timeframe. Since this is a source of ‘revenue’, they are liable to hold their employees accountable for the quality of training satisfaction.
  2. Second, it holds you and your staff accountable – you have a set number of hours to get trained in. You and your staff better pay attention and learn as much as you can.

How much Training?

Here’s a guideline that I have created and found useful after many years of experience. This is based on practice sizes of 1-5 providers. There is variability for individual experience with technology, tech savviness, etc.

8-16 hours: Before starting with the system, but after the system has been setup and customized
4-8 hours: 1 month after going live
4 hours per month: Months 2-6
2 hours per month: Months 6-12

What this means is that in the first year, you need between 44-56 hours training.

So, don’t skimp corners when it comes to training and, please, strive to establish a true partnership. If there are genuine financial reasons why you can’t afford a system that you truly like, tell them. They may work out something for you. But at the very least, have the courtesy of telling them why you can’t partner with them. No one is going to hound you for your decisions. There may be a few ‘used car sales people’ out there, but by large, they want to help you.

Chandresh Shah

‘Tis the Season

It’s this time of year that I find myself reflecting on the year and my life, finding myself thankful for everything I have.  I have parents that have sacrificed so much in their life to provide for me through my youth and even now.  I have friends that I can turn to for anything: advice, support, fun, etc.  I live in a country that is, frankly, the greatest country in the world.  We have folks risking their lives all over the globe to keep us “regular” people safe and free.

I am also a very lucky person to have a job in an economy that is struggling.  But not just any job; I have this job!  I am an Implementation and Training Specialist at Benchmark Systems.  What an amazing position to be in!  I graduated college 8 years ago with a B.S. in Business Administration and a B.S. in Computer Information Systems.  I get to use both degrees.  While in high school, college, and since, I have been on-stage for over 20 theatrical performances, giving me confidence to speak in front of hundreds of people without fear.  Now I get to utilize those talents every time I pick up the phone or travel to a practice to train the staff on Benchmark’s software products.  I have been an active leader in several groups throughout my life, most recently with United Way’s Young Leaders Society.  I have the opportunity to work with people, from all different walks of life and careers, coming together to work on projects for an awesome cause.  And as great as that is, I then get to take those experiences and apply them to my career with Benchmark by being a leader for those practices and their projects I am working with.

All of those things – from school, to theatre, to community involvement – all have one thing in common: meeting new people.  I have discovered that this is the main reason I have enjoyed all of those experiences in my life.  This is also why I love my career here at Benchmark Systems.  I’m not just training practices how to use Electronic Health Records or Practice Management systems.  I’m not just talking to Office Managers, Nurses, Doctors, etc.  I’m meeting real people!  I am meeting folks from North, South, East, and West.  And our discussions do not start and end with medical software.  I’ve been onsite at a practice the day a young lady found out she was pregnant.  I’ve been on the phone with a doctor who was working through having a parent in poor health.  I’ve been visited by an Office Manager and her family from a practice while they were visiting Lynchburg, VA to drop off their son at college.  I have even been a part of a practice’s Holiday celebration because of our great relationship we developed due to my position here Benchmark Systems.

I have so much to be thankful for in life, and the people I work with on a daily basis, both internally at Benchmark and our customers, are a large part of that.  Without the customers – you, reading this blog – and my co-workers, I would not have this career that I look forward to every day I wake up.

Thank you all!  Everyone have a happy and safe holiday season.

Your Friend,
Brandon G. Cyrus
Sr. Implementation and Training Specialist

People Make the Difference

I consider myself a regular person – wife, mom, friend and now, once again a professional.  I earned my degree in the early ‘80s and immediately embarked on a career as a salesperson in the healthcare industry selling practice management systems.  I was diligent, I paid close attention to detail, and I learned quickly and soon rose to the top of the ranks in our company.

After about a decade and a half of a very successful career, my focus changed.  By then, I was married with a toddler and another baby on the way.  We had moved out of state for my husband’s job and although I could continue working for a sister company, due to logistics, lack of appropriate child care, and distance from my family and their support, we made the tough decision.  My husband and I tightened our belts and our budget; although it was very scary and we wondered how we would make ends meet, I joined the ranks of stay at home moms.

It was the best decision we ever made.  It was rewarding and I would not trade one minute of it.  My days were full of potty training, play dates and as my boys grew, volunteering at church and school and I even had the opportunity to train and run a marathon with my then 12 year old son.  I was so proud.  I savored every minute of being there for both of them – what a blessing.

I stayed in shape, was an avid reader and a news junkie.  Although I could see the rewards of staying home, in the back of my mind, I questioned my worth, wondered what my contribution was to my community and my family.  I saw successful women on the morning talk shows and was beginning to question my value.

As my boys entered high school and no longer welcomed my volunteering at their events and the thought of the quickly approaching college tuition popped into our heads, my husband and I decided it was time for me to re-enter the work force.

I was mortified!  Now middle aged and re-entering a field where technology changes in a few short months, I had been away for over a decade.  Luckily, I had stayed in contact with several work associates and soon had a job offer, blessed again.  Like a re-birth, I emerged refreshed and energetic, more mature but with the same strong work ethic.  Although the technology had changed drastically, many things stayed the same.  I found our business is still about relationships.  Today, I enter a practice, meet the office staff and the doctors and they are like me.  They are mothers and fathers and sometimes young people just getting started; I must say, there are many more female doctors than there were in the 80s.  Their goal is still to provide good service and good care to their patients.

I listen, evaluate and recommend a system that will help them be more efficient, more productive, and ultimately help accomplish their goal – provide better patient care.  Today, our emphasis is more on Electronic Health Records but Practice Management is still important and the patient is always the main focus. With the emergence of EHR, our support staff have rededicated themselves to prompt and efficient service; our clients rely on us to help them provide the highest level of care possible.  We’ve expanded our services and our methods of deploying software vary because of the technology available today.  We deploy on client servers in the doctor’s office but more often than not these days we deploy the software over the internet.  In many cases it proves to be more easily accessible and less expensive.

It all comes full circle; technology changes, software advances but what stays the same is the people; it’s all about relationships and providing quality service.  In today’s world technology may take priority over a personal approach but in the long run it’s the people that we rely on that make all the difference.  I guess the world hasn’t changed so much after all.


Micki Brizes
Project Manager at Benchmark Systems

Benchmarking Data

As insurers continue to ratchet down reimbursement rates and deductibles continue to climb, medial practice will require more business management. In easier times, the success of a practice could be measured by its ongoing solvency, number of patient visits and the satisfaction of its patients and physicians. In today’s world, revenue and collections need to be monitored daily.  Practices that manage by looking backwards at the bottom line after the month closes will find themselves seeing ever decreasing revenue. Rising deductibles, copays and lapses in insurance coverage within your patient base makes patient pay an area that needs to be monitored carefully.  Success hinges on managing performance indicators that are vital to a practice’s long-term health. Practices need to have guidelines as to how are they are performing in comparison to the other like practices. Then, all the above needs to be reviewed by the managing physicians easily and quickly every morning as part of the daily routine. Precise timely data is the key to surviving and excelling in today’s ambulatory healthcare. Data and trending comparison within the practice and within the industry can easily be done today. Benchmarking is a proven management technique that allows practices to understand exactly how they are performing so that problems can be identified and corrected quickly. Equally important, benchmarking facilitates goal-setting that is essential to financial health for any medical practice.

Benchmarking is the process of comparing performance. Most medical practices conduct simple internal benchmarking, such as comparing the annual revenue per physician within the practice to identify the top performer and to see how other physicians compare to that individual. While such information may be useful, external benchmarking (comparing the performance of an organization against its peers) provides a much better picture of how well the practice is doing. Indeed, benchmarking is a standard and ongoing activity for many of the world’s biggest companies. Xerox used benchmarking to understand why it lost market dominance to Japanese competitors in the 1970s and to regain its global leadership position in the industry. Historically, few medical practices have used external benchmarking to systematically analyze their performance. However, external factors such as a changing payer mix (or, in some specialties, changes in the practice’s modality or test mix), rising salary and benefit costs, increasing malpractice insurance rates and new audit threats present new challenges to medical groups and require the use of innovative management techniques and tools. Savvy practices are starting to use external benchmarking as a key component of their strategic planning. By comparing a group’s processes and performance against its peers, practice leaders can understand strengths, weaknesses, industry trends and proactively adjust.


Ernie Chastain
Vice President at Benchmark Systems

The Heartbeat of Every Practice

At the heart of every practice that Benchmark is fortunate enough to serve is quality patient care. I’m always working with our staff to be aware of the fact that we have to offer that same level of care on the business side of things to each of these doctors and practices. I enjoy working with perfectionist and it does tend to set the support bar high, that’s a good thing. I also get the fact that doctors and clinicians are 100% focused in taking care of their patients, that’s the calling and they/you have a deep seated drive to do that.

I also know that the heartbeat of every practice should be cash flow with proper accounting procedures and analysis. The difference in a private medical practice and most other privately owned businesses is; one owner focuses on fixing the patient and the other owner focuses on the profits. I’m actually quite comfortable with my doctor focusing on me, it should be that way. What bothers me is the fact that in most cases doctors don’t focus enough on the business side of things. Again, I get it; I understand why….but someone needs to.

So here is the dilemma. If the doctor doesn’t have the time to run the business, is someone with an MBA or at least a BBA hired to manage it? The answer is no, in at least 80% of the ambulatory practices in the U.S., because 80% of those practices in the U.S. are 5 doctors or less and can’t afford an MBA manager. Then ask yourself, could your existing staff run a division of a Fortune 500 company? If that sounds ridiculous to you, think again. They may need help running the business side of your practice. If you look at a 2010 MGMA survey on employee embezzlements, it’s a frightening read with frightening numbers. Then I think for a minute and I don’t have one close friend who is a medical doctor who hasn’t had this happen in his or her practice. Don’t get me wrong, I’m not saying your staff is dishonest, but this survey states, odds are someone will be someday if no one is closely watching. Too many patients, too little time, and not enough attention to the business side……….Not good!

Private practices are now back to the trend of being purchased by the hospitals and large healthcare delivery systems. When this occurs it does take away some of the business stress, but usually leads to a very angry parting of the ways a few years down the road simply because the goals of the doctor don’t match the goals of the hospital. You don’t have to be a mental giant to see that one coming…..….Not good again!

The not so obvious answer is leveraging management costs across multiple practices. Doctors keep doing what you/ they do best. Make a few tweaks to the clerical staff and rather than trying to afford a full time manager with the proper degree, experience and track record hire that profile with a partial FTE structure. Utilize the internet. Today that person doesn’t have to be sitting in your office every day. They are every bit as effective being wired in. Weekly management reviews with structured reports will give you total control and insight, probably better than you have now. You just raised the bar for your existing staff by having a high level employee in the ranks and most will step up to the challenge.

If anyone is interested let me know, I would be ecstatic to put you in touch with each other and even help structure an arrangement. I just want you to be paid extremely well just like the pilot in my next cross country flight. This is no place to be cutting corners for professional services or management. I want the privately owned medical practice to thrive, not become part of a big conglomerate.

Ernie Chastain

The Deductible Season

The first 4 months of the New Year can be a cash flow struggle for medical practices due to the high deductible insurance policies that are in use today. (more…)