Spring Issue April 2010
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Better Living Through Technology

Thanks to the incentive of federal stimulus funding, the push is on for hospitals all across our nation to implement electronic health records (EHRs) and meet federal meaningful use standards by January 31, 2011. The potential eligibility to receive millions of federal dollars through increased Medicare reimbursements between 2011 and 2014 is a very attractive “carrot on the end of a stick,” but the reality of looming penalties for hospitals that have not implemented an EHR by 2015 is an even greater impetus. According to the New England Journal of Medicine, comprehensive clinical health IT adoption by U.S. medical facilities remains low (roughly 1.5 percent) largely due to the prohibitive costs associated with implementing an EHR.

Open source health IT leader, Medsphere, is making it affordable for rural and community hospitals to fully implement an open source EHR system. Medsphere uses a commercialized open source EHR system developed by the U.S. Department of Veterans Affairs. They work with hospitals in a transparent collaboration to calculate estimated stimulus funds each hospital qualifies for through the federal program with a predicted two or three time return on their investment, ultimately enjoying long-term gains in efficiency and automation. This is accomplished by deploying a quality EHR that has been “battle tested” over almost two decades of use by the Department of Veterans Affairs. It is called OpenVista.

While the above claim by Medsphere certainly merits trial evaluation of its EHR tools, a leading practice management expert warns it is too soon for any vendor to guarantee receipt of stimulus funds to its customers. Given that final rules on a standard for certification and the definition of “meaningful use” are expected in June of this year, physicians should make overall benefits of improved practice efficiency, ease of use, and improved quality of care, be the major factors in their purchase decision. He says the electronic medical record (EMR) technology will be a win for all parties because as long as it is properly delivered and implemented, it can improve efficiency and productivity while reducing operating expenses for physicians, and it can ensure better, more comprehensive care at a lower cost for patients.

With all the debate over healthcare reform in the past year, nearly all parties can agree on one thing: the adoption of EMR technology has the potential to dramatically cut costs, improve the quality of healthcare, reduce the risk of tragic errors and eliminate unnecessary duplication of procedures and tests.

Two professional organizations representing the medical transcription sector, Association for Healthcare Integrity (AHDI) and the Medical Transcription Industry Association (MTIA) are vigorously advocating that legislators explicitly acknowledge in those regulations currently being drafted that the dictation-transcription process is a viable means by which “meaningful use” can be achieved, and that EHR systems should be able to receive structured narrative reports from the dictation-transcription process. The concern is the critical importance of keeping a human expert involved in the EHR/EMR process. Too much automation is not a good thing when human lives are in the balance. The long-proven method for documenting care through the dictation-transcription process frees up physician time from cumbersome EHR capture systems and allows them to focus on patient care, promotes information-rich narrative reports for clinical and reimbursement decision support, and facilitates the risk-management role of the medical transcriptionist, whose “extra set of eyes” on the health record ensures accurate, complete capture of patient care encounters, patient records for patient safety, and coordination of care.

In support of their central message, AHDI and MTIA members are providing legislators information on two innovative projects already in place to expedite health information exchange adoption, the Medical Data Exchange and the Health Story Project. The Medical Data Exchange provides a means to accelerate the sharing of a wide range of digital health information between physicians and health care organizations. The Health Story Project is creating document format standards, utilizing a consistent computer-readable structure for clinical records commonly used in healthcare facilities to improve the flow of information between patient narrative and EHR systems.

I hope you will find these and other topics of interest in this spring 2010 issue of TMIS eNewsletter. As always, it is a pleasure bringing them to you.

I am grateful to be in a collaborative business with many talented and skilled professionals. Additional feedback and recommendations for our products and services at TM Information Services are always welcome.

- Mary M. McLaughlin

From the Front Page of TMIS News
Click on links below to view Full Stories.

New Online Tool Helps Hospitals Calculate Health IT Stimulus Dollars Available to Fund EHR
San Diego, California

Medsphere Systems Corporation, the leading provider of open-source healthcare IT solutions, today unveiled a new Stimulus ROI Calculator designed to help hospitals make more informed, financially sound health IT decisions.

"This online Calculator," explained Medsphere President and CEO Mike Doyle, "demonstrates the ability of most hospitals to leverage federal stimulus dollars and totally fund a proven and comprehensive electronic health record solution, specifically, Medsphere's OpenVista EHR. Moreover, our rapid six-to-nine-month implementation process assures OpenVista hospitals that they will be enabled to achieve meaningful use in time to qualify for maximum stimulus dollars. And to let hospitals know how committed we are to helping them achieve meaningful health IT use and thereby meet federal stimulus requirements, we put one-third of our subscription fees at risk."

This automated ROI Calculator uses Medicare and Medicaid discharge information to calculate the estimated federal stimulus dollars a hospital can qualify for by achieving meaningful use as defined by the American Recovery and Reinvestment Act of 2009. The federal government is using ARRA, in part, to impel healthcare organizations to deploy and meaningfully use the health IT necessary to manage costs and improve patient care. The tool helps hospitals estimate five-year subscription fees for Medsphere's OpenVista® EHR solution based on the data they enter (exact figures available upon request). The Calculator then automatically correlates the two estimates -- EHR fees and ARRA stimulus -- to show hospital executives approximately how long it will take to recoup their EHR investment via ARRA.

"As hospitals ponder meaningful use of EHRs and meeting federal ARRA guidelines, they need straight answers from vendors on pricing, time to implementation, achievement of meaningful use and other key issues," said Doyle. "A general lack of vendor openness has made many hospitals reluctant to proceed though they may be leaving millions of sorely needed stimulus dollars on the table.
Full Story

Doctors Should Be Wary of EHR Vendors' Stimulus Fund 'Guarantees'
Lincoln, Nebraska

Amid widespread speculation over proposed incentives for the adoption of electronic medical records (EMR/EHR) systems, physicians and medical practice managers should be wary of vendors promising guaranteed receipt of stimulus funds by their customers.

According to practice management expert Mark Hollis, EMR/EHR vendors that promise physicians automatic qualification and receipt of any financial windfall can, in reality, offer no more guarantee of actually receiving cash than simply purchasing a lottery ticket guarantees one to be a winner. And, he says, physicians should instead focus on the overall benefits of improved practice efficiency, ease of use, and a higher quality of care when selecting an EMR/EHR system for their office.

Financial Incentives Spur Interest in EMR

In late December, the Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare & Medicaid Services (CMS) released preliminary documents aimed at outlining the steps physicians, clinics and hospitals must take to qualify for their share of the more than $17 billion available through the American Recovery and Reinvestment Act of 2009 (ARRA).

With individual providers eligible for up to $44,000 each under certain Medicare participation requirements and $65,000 under Medicaid, as well as the threat of penalties in future years in the form of reduced Medicare and Medicaid reimbursement for not adopting some EHR technology, the stakes seem high for physicians in a time when skyrocketing malpractice insurance premiums and the cost of collecting from uninsured patients cut deeply into revenue.

"Many physicians have been led to believe that merely purchasing a certified EMR solution will guarantee them a much-needed financial shot in the arm in the form of a stimulus payout," said Hollis, president and co-founder of MacPractice, the leading provider of practice management and clinical software for Macs. "I wish that were true, but it's simply not the case. There will be specific criteria to meet, and unfortunately, many physicians, especially non-primary care providers, will not qualify even if they do purchase an EMR system, regardless of the vendor they choose."
Full Story

Dr. Deepak Chopra Releases "Stress Free" for the iPhone: a Coaching Program That Helps People Lead Stress Free, Happier, and Healthier Lives
Pleasantville, New York

Ready to live a life without stress? Dr. Deepak Chopra is putting the keys to a stress-free life right in our pockets. The bestselling author and world-renowned authority in the field of mind-body medicine has created the first mobile step by step program to becoming stress free. The new stress reduction program has been developed specifically for the iPhone/iPod Touch. It features videos of Dr. Chopra as a personal stress relief coach guiding users through a series of daily journaling exercises, guided meditations, music therapy and yoga exercises.

Stress Free is the first in a series of iPhone applications and mobile programs from Deepak Chopra. It also represents the first time such a program is being released directly in an interactive mobile format, without first being released in a book. With his new series of personalized mobile applications, Dr. Chopra intends to provide people with the opportunity of making significant life changes by following daily habit-changing exercises on the go and throughout the day.

The new application combines evidence-based psychology research with traditional Vedic principles. The self-guided program walks users through a set of stress-reduction activities and skills. Throughout each step in the program, users are personally coached by Dr. Chopra in a series of activity-specific videos. Activities include self-reflective interactive exercises relating to one's body, self/ego, relationships and emotions, as well as journaling, questionnaires, music therapy, meditations, yoga exercises and personal nutrition tips based on the concepts of Ayurveda.

"We know that stress is a major contributor to the serious epidemics of our time such as heart disease and cancer; finding ways to combat stress is critical to our health and well being," said Deepak Chopra. "What's so exciting about 'Stress Free' is for the first time, people can access the guidance and tools they need right when they need them most. By following simple daily activities on their phone, individuals can positively change their life perspective and psychological well being."
Full Story

Human/Animal Bond and "Pet Parent" Spending Insulate U.S. Pet Market Against Downturn, Forecast to Drive Post-Recession Growth
New York, New York

Buoyed by the ongoing pets-as-family phenomenon and the "pet parent" sentiment that accompanies it, the pet industry managed to resist the recession and in fact demonstrate growth in 2009, according to U.S. Pet Market Outlook 2010-2011: Tapping into Post-Recession Pet Parent Spending, by market research publisher Packaged Facts.

"The pet market has fared well overall despite the recession, and Packaged Facts attributes this performance to a number of factors that will also be integral to its even better performance in 2010 and 2011," says Don Montuori, publisher of Packaged Facts. "Chief among these factors is the human/animal bond, which is an excellent insulator against recessionary cutbacks, and the 'pet parent' sentiment has never been higher."

Packaged Facts pegs the pet market at $53 billion market (which includes veterinary services, pet food, non-food pet supplies, and non-medical pet services), and expects growth in the industry as the economy moves from recession to recovery. Pent-up pet parent demand for products and services that both enhance pet health and pamper animal companions will begin to kick in during 2010. And Packaged Facts projects sales will reach $72 billion by 2014.

Simply put, many pet owners are as unlikely to seriously cut back on spending for the "pet" family as they are for their "human" family, and in many cases would do so only after reducing spending on their own less essential needs. Such tendencies have typified the behavior of pet owners across the economic spectrum, be they affluent or middle class consumers. What's more, even those pet owners who may have cut back in other areas continued to spend on small indulgences for their pets, which partially explains the increase in sales of items such as dog treats and cat snacks during 2009.
Full Story

Independent Study Indicates That Enterprises View Collaboration, Ease of Use as More Important Than Security When Choosing a Cloud Vendor
Palo Alto, California

CloudShare today announced the results of an independent survey that examines the perception and adoption of cloud computing solutions. The survey sheds light on "What Matters Most in the Cloud" and indicates that ease of use, an all-inclusive business model, and support for existing IT architecture outweighs security as the most important factors for enterprises moving, or considering a move, to the cloud.

The evaluation, conducted by an independent market research firm, issued surveys to representatives from 2,500 enterprises, asking respondents to cite factors driving their particular organization's move towards cloud-based services. The study reveals that while security continues to be an area of consideration for cloud adoption, it is no longer regarded as the number one concern for selecting a cloud provider.
Full Story

Kelly Services, Inc. Moves Into Electronic Healthcare Records Service
Troy, Michigan

To address the growing need for the restructuring of healthcare records, Kelly Services, Inc. has announced its Health Informatics service offering. Health Informatics is the intersection of information science, technology and healthcare and focuses on the application of computer information systems to healthcare and public health providers.

In order to transform the way the healthcare industry manages its data, information technologists are creating a systematic approach to managing individual medical records known as electronic healthcare records (EHR). EHR will allow medical providers to access patients' medical histories and prescriptions nationwide.

Through the American Recovery and Reinvestment Act (ARRA) of 2009, the U.S government has committed significant funding ($20.6 billion) to medical care providers in an effort to encourage adoption of Health Informatics to assist healthcare providers and other entities in adopting and using electronic health records. Healthcare providers must have a required EHR system in place by 2011 to qualify for maximum incentive payments under the federal economic stimulus package. Penalties will be enforced for non-adoption.

As the move to Health Informatics continues, Kelly Services will supply customized healthcare and IT staffing solutions to healthcare organizations around the country to ensure that they are prepared for the arrival of health informatics.
Full Story

Electronic Medical Records and Smart Cards Increase Accuracy
Austin, Texas

Access to a patient's complete medical history on paper is a growing concern for healthcare practitioners, and the Obama Administration. As part of the healthcare reform legislation, President Obama is urging the industry to adopt electronic medical records.

This form of record keeping is seen as a way to prevent inaccurate medical records. In addition to improving patient safety, electronic medical records will also improve efficiencies. The Ash Institute for Democratic Governance and Innovation recently found that electronic medical records are estimated to improve efficiency by 6% per year.

Beyond just the adoption of electronic records, Michael Magrath, business development director for the security division of Gemalto North America, in a post for HealthcareInfoSecurity.com asserts that it is now time for public and private insurers to develop chip-based, smart card electronic patient identity credentials. According to Magrath, these cards offer a secure method of storing basic health information on the card like immunizations, allergies, blood type, emergency contact info, etc.
Full Story

Harness Right-Brain Creativity With New Book "Prescriptions for Living a Creative Life"
Honolulu, Hawaii

A new self-improvement book from corporate and personal coach Neil Tepper promises to help overworked Americans find work-life balance. "Prescriptions For Living A Creative Life: Simple Remedies for Common Maladies in Our 24/7 World" helps readers bridge the gap between left-brain analytical thinking and right-brain creativity to improve all aspects of their lives. Tepper -- a former creative director for The Coca-Cola Company, Universal Television and the 1996 Olympics -- addresses common problems many Americans face today, such as information overload and other stresses that plague our runaway, multi-tasking world.

"In 'Prescriptions For Living A Creative Life,' I show how today's high-tech information age is shifting to a high-touch inspiration age, where personal fulfillment is as valued as business success," said Tepper. "By following my 'Prescriptions,' readers will learn how to harness their right-brain creativity to break through old beliefs and behaviors that don't align with who they are now. 'Prescriptions' will enable them to bring more happiness and meaning to their lives."

Tepper demonstrates his "logical creative" approach: how too much information can make us less effective, how doing less can make us more productive, and how we can operate with peak performance and less stress. Chapters include workbook pages to guide readers in applying the principles in their everyday lives.
Full Story

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