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.


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.


4 Reasons Why You’ll Need an EMR for ICD-10

With the switch to ICD-10 looming on the horizon, many healthcare providers are searching for a catch-all solution to ensure a smooth, snag-free transition. As this article points out, while there’s really no “magic bullet” for ICD-10, adopting an electronic medical record (EMR) will definitely help ease some of the pain associated with implementing this new diagnosis code set. In fact, the thought of tackling ICD-10 without an EMR is close to inconceivable. Here’s why:

1. It will be your life preserver in a sea of new codes. If you’re overwhelmed by the sheer number of codes included in ICD-10, you’re not alone. To give you an idea of the scope, there are more than 68,000 ICD-10 diagnosis codes and 72,000 procedural codes. For comparison, ICD-9 has 13,000 diagnosis codes and 4,000 procedural ones. Add to that a complete overhaul of the actual code structure—ICD-10 codes contain up to seven characters, whereas ICD-9 codes only contain up to five—and you’ve got a recipe for a serious panic attack. But if you have the right EMR, you can breathe easy—or at least easier. Good EMRs feature built-in intelligence to help you select diagnosis codes based on the information you’ve recorded in your documentation. That way, you don’t have to thumb through hundreds and hundreds of pages of diagnosis codes to find the one you’re looking for.

2. It will ensure you code as specifically as possible. In addition to helping you find the right code for each diagnosis, an EMR also will prompt you to code to the greatest possible level of specificity. For example, as explained in this blog post, some diagnosis codes require a related external cause code to indicate the origin of a patient’s injury or condition. These codes do not exist within ICD-9, so remembering to add them might prove difficult at first—unless you have an EMR that remembers for you. And with everything else you’ve got on your plate, that peace of mind could be huge—especially considering that payers will come to expect this information to be readily available on patient claims.

3. It’s a big piece of the interoperability puzzle. In their quest to increase the efficiency and quality of patient care in all specialties, healthcare leaders all over the world have pushed for a medical landscape with fast, seamless information exchange—a.k.a. interoperability—across all healthcare platforms. The global move toward ICD-10 represents a huge part of this initiative as it allows for uniform coding of complex information, thus making the resulting data easier to share. But true interoperability cannot exist without effective communication and adequate technology—and that’s where EMR comes into the picture. In this day and age, it would be nearly impossible to achieve constant interconnectivity and communication across all healthcare providers without across-the-board implementation of secure, portable, cloud-based EMR systems.

4. It will allow you to focus on what truly matters—your patients. The magnitude of the transition to ICD-10 could easily pull your attention away from your ultimate goal of providing exceptional care to each and every patient. But with an EMR, you’ll have a partner to tackle some of the tedious code selection stuff so you’ll have the bandwidth to handle bigger-ticket tasks—like helping your patients achieve amazing outcomes through therapy.

So, before you pull your hair out over this whole ICD-10 switch, be sure your practice has all of the tools necessary to make the transition as painless as possible—chief among them: an EMR.