The EMR Mandate

Per the American Recovery and Reinvestment Act (ARRA) of 2009, all eligible public and private healthcare providers across the US must have adopted an electronic medical record (EMR) and demonstrated meaningful use by January 1, 2014, to continue receiving Medicare and Medicaid reimbursements.

Incentives and Penalties

To facilitate this transition—which meets the United States’ goals of improving quality, safety, and efficiency; reducing medical disparities; engaging patients and family members; improving care coordination; and maintaining privacy and security—the government is offering financial incentives for compliance and assessing penalties for non-compliance. Specifically, according to this CMS webpage, eligible providers can receive up to $44,000 and/or up to $63,750 through the incentive programs for Medicare and Medicaid, respectively. On the other hand, eligible professionals who don’t implement an EMR and/or fail to demonstrate meaningful use by 2015 will face a 1% reduction in reimbursements—and experts speculate that this “rate of reduction will likely rise annually thereafter.” Some say penalties will reach 5% in coming years.

Meaningful Use

So what does meaningful use actually mean? Well, it means that providers must use an EMR that meets specific Centers for Medicare and Medicaid Services (CMS) requirements. These requirements are organized in stages: stage 1 requirements must be met for at least nine months in the first year and 12 months in the second; stage 2 requirements must be met for 12 months in both the third and fourth years. However, according to CMS’s website: “For 2014 only, all providers—regardless of their stage of meaningful use—are only required to demonstrate meaningful use for a three-month reporting period. For Medicare providers, this three-month reporting period is fixed to the quarter of either the fiscal (for eligible hospitals and CAHs) or calendar (for eligible professionals) year in order to align with existing CMS quality measurement programs, such as the Physician Quality Reporting System (PQRS) and Hospital Inpatient Quality Reporting (IQR).” To complete stage 1 requirements, eligible professionals must meet 19 (out of a possible 24) meaningful use objectives:

  • Fourteen required core objectives (e.g., maintain active medication list, implement drug-drug and drug-allergy interaction checks, or record smoking status for patients aged 13 years or older.)
  • Five objectives from ten menu set objectives (e.g., implement drug formulary checks, incorporate clinical lab-test results into record system as structured data, or send patient reminders per patient preference for preventive/follow-up care.)

Specification Sheets

Looking for more specifics? CMS provides downloadable specification sheets that include definitions, clarifications, and information about:

  • Meeting the measure for each objective
  • Calculating the numerator and denominator for each objective
  • Qualifying for an exclusion to an objective
  • Attesting to each measure

For Therapists

Although EMR adoption improves the nature of health care for patients and practitioners in every facet of the industry, not every medical professional is considered eligible. Thus, not every medical professional is mandated to make the switch or eligible to earn the incentive for doing so. For example, the Act does not consider physical therapists, occupational therapists, or speech-language pathologists eligible professionals. That’s why PTs, OTs, and SLPs should look for a rehab-therapy specific EMR and disregard the requirements for meaningful use. After all, there are all sorts of benefits associated with switching to an EMR, even without the promise of an incentive. And as the APTA points out: “While physicians and hospitals are the beneficiaries of many of the federal government’s initial efforts to encourage [EMR] system adoption, they will expect the other providers they work with, including physical therapists, to implement it as well. Patients also may begin to expect their providers to use [EMR]s to manage their care.”

What do you think about the EMR Mandate? Tell us your thoughts in the comments below.


Three Things You Can Do To Make Your EMR Implementation a Success

So, you’re pretty sure, fairly positive, almost certain you’re ready to pull the trigger on a new EMR for your practice. Congratulations! You’re making a wonderful decision for yourself, your staff, and your patients. But, before you take the next step, take a few minutes to read this post. Here are three things you should do to ensure your EMR implementation is a success:

1. Choose the Best EMR

First and foremost, if you’re a physical therapist, you should choose a physical therapy-specific EMR. It sounds like a no-brainer, but you’d be surprised how many clinicians overspend on a one-size-fits-all solution and then end up wasting precious time on workarounds and Band-Aid fixes because the product simply doesn’t meet their needs. Scrap that. Choose a niche EMR—preferably one developed by a physical therapist—and you’ll have everything you need to do to your job well—like intuitive SOAP notes, 8-minute rule alerts, referral tracking, integrated functional limitation reporting, and a registry-based PQRS program.

Second, make sure you choose a true cloud-based EMR (over a server-based one). That way, you won’t need to hire additional IT staff to get your clinic up and running—or to maintain your system. With cloud-based solutions, you and your team can be fully trained in a matter of hours, and all system updates occur automatically. Talk about easy onboarding. Plus, you can securely access your patient records and scheduling information from anywhere at anytime, which means no more staying at the office late to finish your documentation. And because cloud-based EMRs boast the very best in data security, your important information will remain safe and sound for as long as you need it, even in the event of power outages, natural disasters, or office break-ins.

2. Use the Right In-House Technology

Just as not all EMRs are created equally, not all techy tools are created equally either. Make sure you know what technology is compatible with your new EMR. For example, if you just purchased a whole new fleet of MacBooks for your staff, you’ll probably want to make sure that your new EMR will work well on your new devices—or you might have to trade them in for PCs or choose another EMR. And that goes for more than just laptops. Also consider your internet connection speed, wireless router, scanner, operating system, and hardware. Using the right in-house technology for your EMR will allow you and your staff to benefit from all the speed, tools, and features that the system has to offer. Using anything less would be like putting regular fuel in a Maserati.

3. Get More Than Buy-In From Your Staff

Without support from your team, you’re looking at an uphill battle—even with the very best EMR and the right in-house technology. But this doesn’t necessarily mean you have to take a democratic approach—after all, change often spurs some pretty strong resistance (at least at first). According to Karen Fuller, principal of CSC’s Health Delivery Group, decisions to change technology should take a top-down approach with leaders presenting an unwavering commitment to the shift. That being said, she also recommends that leaders hold “vision sessions,” where everyone comes together to discuss the potential benefits of the change—things like how an EMR “can improve patient safety and care.” This type of group discussion helps everyone achieve a shared vision of the implementation goal.

Dr. Cliff Bleustein, managing director and global head of healthcare consulting for Dell, recommends giving your staff some hefty responsibility: “When you implement an EMR, your clinical and business staff members have to be fully involved and fully accountable for the results, or you’ll end up with a disaster. Mere buy-in from your clinicians and business staff is not enough. They have to do the actual planning and implementing themselves.”

No matter how you choose to go about this process, focus on the positives, allow for open communication, and be patient. The more support you’re able to garner from everyone in your office, the better off everyone will be. Looking for more advice on how to pitch an EMR to your staff (or your clinic director)? Check out this article.

There you have it: Three things you can do to make your EMR implementation a success. Have any questions about what we’ve discussed here? Let us know in the comments section below.


Give Yourself the Gift of EMR

The traditional gift-giving holidays are all behind us now—even Cupid has holstered his bow and arrow—but that doesn’t mean you can’t treat yourself to something really nice just because. Give yourself the gift of EMR this spring, and say goodbye to writing, filing, and lugging paper charts—a pain, whatever the season. And that’s not all. With the right EMR, you’ll get these other great gifts that just keep on giving, too:

Legible, Accessible, and Defensible Documentation

All physicians must transition to EMR by 2014, and there’s a reason for that: compared to paper charting, EMRs are better able to provide the medical community as a whole with legible, accessible, and defensible documentation. And that’s important for both patients and providers, especially as we continue to move further into this pay-for-performance, regulation-heavy healthcare environment. With an EMR, your documentation will better tell your and your patients’ stories. And you’ll never again have to sort through another towering stack of filing cabinets in search of a certain note, only to find that you can no longer read the chicken scratch that once passed for handwriting.

A Partner in Compliance

Each reporting regulation has its own unique—and often messy—set of requirements, but with the right EMR,  you’ve got a partner in compliance. Instead of stressing about all the hard-to-keep-straight details—like those for PQRS, functional limitation reporting, the 8-minute rule, and the therapy cap—you need only follow the built-in prompts and alerts to complete the requirements for the right patients, every time. Plus, your EMR can help you manage the transition to ICD-10.

Unmatched Safety and Security

Choose a cloud-based EMR, and your patient data will be safe and secure—always. You’ll have all the perks of the world’s leading data centers—like protection from natural disasters, digital video surveillance, biometric screening, and round-the-clock guards—and none of the cost or responsibility.

A Leg-Up on the Competition

For most physical therapists, referrals make up a large part of new business. With an EMR, you can maximize those referrals by tracking how many you receive and from whom. It’s a great way to identify those in your network who need a little more attention and those who deserve a big “thank you.” With an EMR, you can also display your clinic’s logo on all of your digital documents, so every note you send is a reminder to prospective referrers of your skills and professionalism. Talk about a big leg-up.

Now’s the perfect time to nix perilous paper—think of it as an extension of your annual spring cleaning—and make 2014 a year to remember with the best gift you, your clinic, and all the trees of the world could ask for: EMR.


PQRS 2014: Why Go Registry-Based with an EMR

At the end of November, Medicare released its Final Rule, which, among other things, included all the nitty gritty details of next year’s physician quality reporting system (PQRS). And if there was any doubt that registry-based reporting with an EMR was the way to go in 2013, there isn’t any in 2014. Here’s why:

1. Registry-based reporting is much easier.

Your first decision when it comes to PQRS—assuming that you’ve already acknowledged that it’s in your very best interest to comply—is which reporting method to use: claims-based (lots of work) or registry-based (easy as pie). You see, with claims-based reporting, it’s all on you. You’re responsible for remembering what to report, for whom, and how frequently as well as for correctly documenting and submitting the data to Medicare. With registry-based reporting, on the other hand, your EMR will take care of the heavy lifting for you. It’ll prompt you to answer the necessary PQRS questions at the required times during normal documentation, compile the data for you, and electronically submit it to CMS on your behalf. With registry-based reporting, you may even have enough time left over to actually bake that pie.

2. There’s a hefty penalty for noncompliance.

If you’re not PQRS compliant in 2014, Medicare will assess a 2% payment adjustment in 2016 (up from 1.5% in 2013). Also, next year may be the last year that you can earn an incentive—0.5%—for compliance. So now is definitely not the time to take on all the intricacies and complexities of PQRS on your own—especially considering that the requirements for compliance just got a whole lot tougher.

3. With registry-based reporting, you’ve got way more options.

In 2014, the easiest way for physical therapists with a large number of Medicare patients to avoid the penalty and earn the incentive is to report the Back Pain Measures Group for at least 20 patients, most of whom must be Medicare Part B fee-for-service (FFS) patients. Sounds great, right? Well, the only way to use the measures group reporting option is to do so through a registry.

If you’d rather not use the measures group option because maybe you don’t treat many Medicare patients, you can still use a registry to avoid the penalty and earn the incentive by reporting nine measures, covering three national quality standard (NQS) domains, on at least 50% of your Medicare Part B FFS patients. You can do so as a group (GPRO) or as an individual.

Through claims, you can only report as an individual, and the reporting requirements (nine measures, covering three NQS domains, on at least 50% of Medicare Part B FFS patients) remain the same. However, there are only eight claims measures that apply to physical therapists, which means that all PTs who opt to use claims-based reporting are subject to the Measures Applicability Validation (MAV) process. This is how Medicare will determine if an eligible professional should have reported additional measures and/or covered additional NQS domains. In other words, it’s just another potential PQRS complication.

You already have enough on your plate—like running your business, treating your patients, and preparing for the ICD-10 transition. Don’t take on PQRS all by yourself. Instead, choose registry, and you’ll have a partner in compliance and a significantly better and less stressful 2014.


Three Ways an EMR can Boost Your Compliance Confidence

Feeling confident about compliance is rare among most healthcare professionals—and that includes rehab therapists. Of course, most PTs know the terms “therapy cap,” “functional limitation reporting,” “PQRS,” “the 8-minute rule,” and “MPPR,” but, in our experience, few can say with confidence that they are fully compliant—especially without the help of an EMR. Yet, compliance requirements remain in place, and payment denials, penalties, fines, audits, and a whole lot of complications await those practitioners who don’t take the requirements seriously. So, if an EMR can help you boost your compliance confidence, what are you waiting for? Here’s proof:

1. Complete Documentation

Each regulation has its own distinct and often complicated set of documentation requirements, but the right EMR can sort all of that out for you; you just follow the prompts and alerts. Take functional limitation reporting, for example: therapists must record a patient’s primary functional limitation, the severity of said limitation, and a goal for therapy at the patient’s initial evaluation, re-evaluation (if applicable), progress note (at minimum every ten visits), and at discharge. The right EMR will prompt you to select the appropriate G-codes and modifiers on the correct patient visit and will carry over all relevant patient information. In other words, the right EMR can make functional limitation reporting significantly less daunting (dare we say, easy?).

Want another example? Let’s talk PQRS. There are two PT-specific EMRs on the market right now that CMS has approved as PQRS Certified Registries. So if you choose one of these applications, you’ll need only to select your reporting measures and answer a few simple questions during normal documentation. The registry will collect, aggregate, and digitally submit all the appropriate data to CMS for you. You’ll satisfy the requirements, avoid the penalty, and even earn an incentive.

Still not convinced? EMRs also have you covered when it comes to Medicare Plan of Care tracking reports and alerts; certification and recertification reminders; and 8-minute rule alerts. Plus, a PT-specific EMR can streamline your documentation process and reduce double data-entry and human error that could cause all sorts of compliance issues. And storing all your documentation digitally means that it will always be neat, organized, legible, and easily accessible should you ever need to search your records or review past notes.

2. Automatic Updates

A cloud-based (a.k.a web-based) EMR is always up-to-date. If Medicare creates a new regulation or modifies an existing one, this type of application can adapt quickly, rolling out new features and upgrades to provide you with the latest and greatest technology. And the best part is that cloud-based EMRs update seamlessly and automatically, which means you don’t need to lift a finger to access to the newest version. For comparison, updates to server-based EMRs are significantly more labor and time-intensive. As a result, they’re often much less agile and flexible, which means they become outdated quickly—and that’s a big problem considering the pace at which Medicare introduces new (or makes changes to existing) regulations.

3. Expert Support

It’s not just the system that stays up to date on the latest in compliance regulations; a good EMR vendor’s staff does as well. And that means you, as a customer, automatically have access to your own personal team of experts, at your service and always ready to answer your most challenging compliance questions. These answers can come in the form of online educational content—like blogs, newsletters, and webinars—or one-on-one support calls.

Simply knowing that you’re not alone in this compliance jungle can be quite the confidence booster. And in this day and age, it’s nearly impossible to remain fully compliant without the help of an EMR. So don’t wait any longer. If you haven’t already, start seriously considering how an EMR can be your best friend when it comes to staying compliant—and staying in business. And with the weight of compliance off your shoulders, you can focus on doing what you really love—providing exceptional patient care.


5 Questions to Ask when Evaluating an EMR Company

The Internet’s a wonderful place, a place where you can find just about anything your heart desires—from the recipe for your favorite restaurant’s puttanesca to step-by-step directions on how to go green in your clinic. It’s also where you can find information about the products you need to keep your business running smoothly, including information about electronic medical records (EMRs). Here are five questions to ask when evaluating an EMR company:

1. What are people saying about the company?

While you certainly shouldn’t believe everything you read online, you can use a few good Google searches to give yourself an idea of what people think about your potential vendor (partner, if you choose the right one). Pay attention, of course, to information about the product—features, tools, services—but also note how people are writing about the company itself as well as its executive team and their interactions.

Not sure where to start your search? Try a few basic keyword searches, like “physical therapy EMR” and “PT software.” Companies that show up at or near the top of the list are usually pretty popular. They typically get a lot of traffic—and customers—which means they’re doing something right.

2. What’s the company’s focus?

Understanding who the company is aiming to serve (e.g., rehab therapists, chiropractors, physicians, the medical professional kitchen sink) is incredibly important because with that knowledge, you’ll be able to predict where the company is heading. You are, after all, looking for a long-term partner that’s going to help you be better in business, right? So you need an EMR that’s designed for you—one that has unique industry- and speciality-specific knowledge, one that’s going to adapt to meet your needs as they change and grow over time. And with the way documentation legislation is heading (think: PQRS, functional limitation reporting, ICD-10), there’s bound to be a lot more change ahead.

3. Is the company in beta?

When a software company is beta testing, it’s asking consumers to use its product and provide feedback, which can benefit both the company and the consumer. However, there’s also a significant amount of uncertainty for the user in this type of arrangement. After all, the company may not ever make it out of beta and that means starting over anew.

If you’re considering a company in beta, be sure to find out how long they’ve been there, because anything more than five months can mean that the product isn’t well received and/or there are bugs and system issues.

4. How much is the company growing?

When shopping for EMRs, consider the company’s growth rate—internal and external. Pay attention to the size of the company, how many employees it has, and what those employees’ roles are. A company with one or two people who do both sales and customer service, for example, is a red flag; either the company can’t afford to hire more staff or doesn’t need to because of a small customer-base. And the last thing you want as a new user is getting a busy signal when you have a question.

Also consider how long the company has been on the market and the number of customers it serves. Remember, longevity doesn’t necessarily mean that the company offers a good product, but a large number of customers, increasing year after year, probably does.

Speaking of growth, it’s also important to consider a company’s customer retention rate—that is how many users remain year-over-year or month-over-month compared to those who leave. Here’s a hint: A ratio higher than 90% is good; anything over 95% is excellent.

5. Does the company appear solvent?

A solvent company (one that has assets in excess of liabilities and is able to pay its debts) can afford to spend money where it matters, like on developing new features and services or ramping up marketing efforts to bring in new business. Can you find company press releases online announcing the roll-out of new products and features? Have you seen company advertisements in local periodicals and sponsorships at rehab therapy events? Take a look at the company’s website. Is it professional? Does it include high-quality content, like educational webinars and blog posts? While appearances definitely aren’t everything, it’s always a good sign when a company presents itself well online and off.

There you have it: five questions to answer when evaluating an EMR company. While most of this information is available online, you can also give your potential EMR company a call to fill in any gaps. What else do you think is important to consider? Tell us in the comments below.


Social Media + EMR. Awesome or Awful?

Social Media

Social media is all the rage these days—and that goes for Facebook (with 1.5 billion active users), Twitter (with 200 million), LinkedIn (with 238 million), and Pinterest (with 70 million). And these numbers are increasing steadily. Take Facebook, for example. The 1.5 million active users I referenced above is 23% more than the number of active users the company had in early 2012. That’s enormous growth in just a year. According to Zephoria, this should quell any lingering doubts you may still have about the The Social Network because—statistically speaking—“Facebook is too big to ignore.” And as far as we’re concerned, so are the rest.

Hopefully, you’re tapping into the magic that is social media to enhance your marketing efforts, but that discussion is for another time and place (cough, the WebPT blog). Here, let’s talk about electronic medical records (EMRs) and social media. After all, EMRs are all the rage these days, too.

EMR

Want some proof about the prowess of EMR? According to this USA Today article, in 2008, only 9% of hospitals and 17% of physicians used electronic medical/health records. Today, more than 80% of hospitals and 50% of physician offices that contract with Medicare or Medicaid will transition by the end of this year. Physical therapy EMR adoption is up as well—just ask the APTA. Why the increase? Well, in addition to the government incentivizing physicians’ offices and hospitals that make the switch, there are also countless benefits for both the practitioner and the patient. Oh, plus pen and paper are so last decade.

Social Media + EMR

Now that we’ve talked about social media and EMRs individually, let’s talk about them together. Today, people are sending more than 400 million tweets and posting more than 55 million Facebook status updates every day. You read that right: every day. That’s a ton of information. So how does that relate to health care—and more specifically, to EMR? Well, back in 2009, health care was the eighth most popular Facebook status trend out of all potential possibilities. Additionally, according to Jennifer Bresnick, author of an EHR Intelligence article about the role of social media in electronic health records, “millions of people share the intimate details of their lives with their network of friends and acquaintances. They might complain of feeling nauseous after taking a new medication on Twitter, but not think it’s worth calling their doctor about, or post a picture of their swollen ankle after a fall without realizing they should be seeking medical attention for a sprain.”

Opportunities

Looking for more evidence of the overlap? Check out this article written by WebPT’s very own Senior Writer, Charlotte Bohnett. In it, she cites a PwC study that found 41% of people surveyed would allow social media sites to influence their choice of a specific medical professional or facility. That’s huge. So it’s no wonder that medical professionals are becoming more and more interested in the conversations happening on social media. This Healthcare Technology Online article quotes Jared Rhoads, senior research specialist with CSC’s Global Institute for Emerging Healthcare Practices, who says, “It stands to reason that there are tremendous opportunities for [medical professionals] to tap into social media tools in order to get patients to become more engaged in their care. Information and data that are obtained or generated as a result of these interactions have a valid place in the patient record—as valid as nearly any other self-reported piece of information.”

In the same article, John Edwards, a PwC spokesman, said that “hospitals are using social media, and they are not limiting their imaginations to just marketing and listening to people’s feedback about the company; they are starting to think about how to use social media for services and other aspects of their business.” Shouldn’t you be, too?

Challenges

Rhoads cautions, though, “this is also relatively uncharted territory, and so best practices have not been widely established.” That may be part of the reason why, according to Bresnick in the EHR Intelligence article I cited above, standalone healthcare-centric networking sites, like tibbr, which is designed to facilitate health information exchange through a “Facebook-like interface,” haven’t taken off yet. Bresnick believes that “the business case for truly integrating patient information gleaned from social media hasn’t yet been convincingly made, nor have developers and big data specialists figured out how to separate the wheat from the chaff when combing through Instragram updates.”

Another potential obstacle to consider? Patient privacy. If healthcare organizations, practices, and facilities begin to rethink the use of social media tools to enhance the patient care experience or add additional context to a patient’s medical record, a new breed of security measures will become necessary. In the same article, Bresnick quotes Deborah Kohn, MPH, RHIA, FACHE, CPHIMS, principal of Dak Systems Consulting: “Every tweet, blog comment, text message, and wall entry you and/or your organization colleagues upload or receive is a piece of content that, theoretically, should be reviewed and managed to ensure control, decorum and, perhaps, regulatory and records compliance. For example, an individual social network status update or a tweet might not rise to the level of a record, but a protracted discussion on a particular topic over a given period on someone’s wall or via Twitter might qualify.”

The Future

So what might EMRs look like in the not-so-distant future? According to Missy Krasner, product marketing manager of the short-lived, before-its-time Google Health, “They [won’t] just say: ‘we want to structure your data’; now [they’ll say:] ‘we want to connect you with other people who have your same illness, if you’re comfortable with that.’” In other words, an integrated EMR with a patient portal that allows individuals to collaborate with their healthcare providers and their peers may be just what the healthcare community needs to increase access and quality of patient care.

What do you think? Does social media have a place in modern health care? How do you see it being integrated with electronic medical records? Tell us in the comments below.


5 Reasons Why a Free EMR isn’t All That

When it comes to an EMR, there’s no such thing as a free lunch, and if it sounds too good to be true, it probably is. I could rattle off clichés ’til the cows come home, but you get the point: you get what you pay for. Now this isn’t always the case; there are plenty of fantastic services, experiences, and products out there that also happen to be fantastically free. But these are not the services, experiences, and products that store and transmit your patients’ protected health information. Nor are they the ones that ensure you are fully HIPAA and Medicare compliant. And they are certainly not the ones that help you run a better practice—and receive proper reimbursement. Here are five reasons why a free electronic medical record (EMR) is not all that it’s cracked up to be:

1. Obnoxiously Ad-Supported

Many companies use advertising dollars to cover the would-be cost of their services to the consumer. Just think about a free version of your favorite mobile game. Angry Birds, Words with Friends, and Candy Crush all offer versions paid for by advertisers. And that’s perfectly fine. Often, being unable to proceed to the next level until you watch an OKCupid ad is nothing more than a minor inconvenience—well worth the savings. Contrary to what some serious Angry Bird addicts might say, it is just a game.

But, what happens when the same ad stops you from finalizing your SOAP notes? Or distractingly fills the margins of your documentation system? What would your patients think if they saw your documentation platform speckled with advertisements? Does ad-supported technology scream professionalism or credibility? After all, an advertisement’s job is to sell you—and a patient’s visit is probably—definitely—not the right time for that.

2. Frustratingly Non-Specific

Many of the free electronic medical records on the market today are made for physicians but marketed to the medical professional kitchen sink. That is, for a rehab therapist to use this type of a system, he or she would have to create Band-Aid fixes and workarounds because the system isn’t tailored to a therapy-specific workflow. At first, this might not seem like a big deal, but when you think about how many patients you see each day and how much time you spend documenting, every frustratingly wasted second adds up—quickly. What else could you do with that time? See a few extra patients? Get home to your family sooner? There are a lot of things that sound better than fiddling with a physician-specific system until it—sort of, kind of, almost—works for you.

3. Questionably Unstable

Most companies only stay in business if they can make a profit. Take a look at your clinic, for example: You might love to perform all your sessions pro bono because you know how much your patients would appreciate it, but you can’t. If you did, those patients wouldn’t have you as a therapist a few months down the road when you could no longer employ your staff or pay your electricity bill. So, unless the free EMR company has a very wealthy, altruistic benefactor who just wants to be loved by all (even Santa asks for compensation, albeit in milk and cookies), the company has to—at some point—start bringing in some moolah. If it doesn’t, it runs the very real risk of going under and taking your data down with it—leaving you to start over from scratch.

4. Concerningly Outdated

Without extra funds to spend on updates, new technology, and new staff, it’s quite likely that your free EMR still looks—and acts—like a relic of the ’90s. While you may still get a kick out of DayGlo and side ponies, things certainly have changed since then, especially in our healthcare landscape. If your system can’t keep up with the latest healthcare legislation and documentation regulations, you’re going to be in for a long haul of manual claim submissions and double-checking compliance standards in 500-page government-written documents—and we all know how clear as mud those are.

Shouldn’t your EMR do some of that heavy compliance lifting for you? What are you paying them for? Oh wait, you’re not.

5. Irritatingly Unsupportive

If the company doesn’t have the money to spend on technological advancements and upgrades, how much do you think they’re going to spend on customer support? So what happens when you have a question, a problem, or just want to voice your opinion? You’ll either be left talking to voicemail or getting someone on the phone who might as well be an automated system because he or she doesn’t have an answer. The good EMRs—the ones that constantly evolve, innovate, and improve—are the ones that value their members’ opinions and make themselves available to offer the very best in customer and technical support.

Bottom line: Your documentation is important. It’s how you prove to the world that you are fantastic in your field; that you produce measurable improvements in your patient’s health and mobility; and that you are at the top of your professional game. Choose an EMR that’s worthy of you. And if you have to shell out a few dollars a month for it, that’s okay. Not only are you contributing to the success of a business that you rely on, but you’re also making a statement to the world that the service you’re paying for is a service well worth its price. You shouldn’t settle for an EMR that provides you with anything less.

Do you have experience using a free EMR? How was it? What did you like or not like about the system? Tell us in the comments below.


How to Decipher Healthcare Jargon (Acronym Alphabet Soup)

If you’ve been reading the latest in healthcare regulations, rulings, and requirements, you’ve probably done a good deal of head-scratching. Not only is the writing clear as mud (I’d be remiss not to plug the benefits of good copywriters here), but the US government has also created its own language of initialisms—not all that surprising if you consider the government’s track record (think CIA, FBI, NSA, etc.).

But before you get bogged down with these new two-, three-, and five-letter words—and start shouting out a few choice four-letter ones—we thought we’d give you a helping hand. Here’s how you can decipher this acronym alphabet soup—sans Cracker Jack decoder ring.

HIT: Health information technology (or health IT) is the electronic exchange of health information.

EMR: Electronic medical records are digital versions of a clinicians’ paper charts. Together, they make up an electronic medical record system, which contains the treatment history of patients within one clinic or group.

EHR: Electronic health records are also digital versions of clinicians’ paper charts. However, electronic health record systems are designed to share information among providers across healthcare organizations (e.g., hospitals and physician’s offices).

PHR: Personal health records are patient-managed, online health records that can come from a variety of sources. For perspective, EMRs and EHRs are provider-managed health records.

HIPAA: The Health Insurance Portability and Accountability Act of 1996 contains the Privacy Rule, which establishes how certain groups, clearinghouses, organizations, and businesses must handle protected health information (see PHI below).

PHI: Protected health information is individually identifiable health information relating to the past, present, or future of any of the following:

  • Physical or mental health or condition
  • Provision of health care
  • Payment for the provision of health care

BA: A business associate is a person who, or an organization that, performs a HIPAA-regulated function or activity on behalf of a covered entity (e.g., an EMR).

CE: A covered entity is a healthcare provider, a health plan, or a healthcare clearinghouse that transmits HIPAA-covered health information.

BAA: A business associate agreement is a contract between a covered entity and a business associate that outlines how each party will address PHI in accordance with HIPAA guidelines.

There you have it—we’ve deciphered some of the most common two-, three-, and five-letter initialisms courtesy of Uncle Sam. Did we miss a piece of healthcare jargon that has you in a huff? Leave us a note in the comments section, and we’ll help you crack its code, too.


The Future of Electronic Medical Record Management (Part 3)

[If you’ve already ready Part 1 or Part 2, jump to the subtitle below.]

The year is 2013, and although we don’t have the technological advancements of say, The Jetsons, we certainly have come a long way. In the last decade, smartphones became omnipresent, Google became a verb, and social networking changed the way we interact with one another. Never before have we had access to so much information—literally—at our fingertips. And although there’s no question that we as a society take full advantage of the newest and neatest technological advances to make our personal lives easier, we don’t always do the same when it comes to our professional ones.

Want an example? When was the last time you hand-wrote three pages of anything in your personal life? I’m guessing—unless it was a sentimental letter in which you chose handwriting to make it more personal—it’s probably been awhile. When was the last time you hand wrote three pages worth of paper charts? Today? This morning? Every day, every hour, every patient visit? Unless your intention is sentimentality here, too, that doesn’t make much sense—especially when you consider that there has been just as much advancement in the world of electronic medical record (EMR) systems as other techy tools. And that’s not going to stop.

Over three consecutive posts, we’re going to share with you what the experts are saying about the future of electronic medical record management. Here is Part 3 (click here to read Part 1 and here to read Part 2):

Integration, integration, inte…interoperability?

The ultimate purpose of widespread EMR adoption is to improve the quality of healthcare across the board. In an article titled, “Electronic Medical Records (EMR) and the Future of Healthcare, the author writes: “…information exchange, sharing, and interoperability represents one of the most compelling EMR benefits that can secure a viable future for healthcare.” Because there will be no one-size-fits-all system, we must work to ensure that the best solutions can talk to one another. After all, in an ideal world, one very complete medical record will follow every patient across his or her lifespan. As a result, every medical professional who sees that patient will have access to a full medical history—everything from immunizations and allergies to rehabilitative plans of care and X-rays. According to the article cited above, this will result in “upgrading the quality and integrity of healthcare intervention to the point of significantly reducing healthcare costs while saving millions of lives annually.”

With this in mind, it’s important to note that just because a system used to work, doesn’t mean it will continue to do so in the constantly evolving healthcare technology environment. As the Office of Standards & Interoperability (OSI) at the U.S. Department of Health and Human Services states, older systems “may not be fully compatible with newer products. Systems that predate current standards may require installation of applications that function as translators.” In other words—and to tie in with the section above—older, legacy (read: server-based) systems just don’t cut it on their own anymore.

Additionally, a siloed system that doesn’t integrate with your billing software, scheduling system, or functional limitation reporting tool, to name a few, will not work well in the long run. In fact, if one main benefit of an EMR is to cut down on errors, you want a fully integrated system with plenty of checks and balances. This way, you’ve minimized the risk of human error as a result of data entry.

So what’s the main takeaway? What can we expect the future of electronic record management to look like? Well, for one, EMRs are here to stay—specifically, cloud-based, fully integrated, working-toward-interoperability ones—and the days of paper charting are numbered. Now, the only question left unanswered is: What are you going to do about it? Hold out until the very last minute—until your patients start seeking out a more with-it provider? Or get ahead of the curve and enter the land of EMR? We hope it’s the latter. In the meantime, check out this lighthearted infographic from Dell on the future of EMRs.