Is Speech Recognition Software Really Worth The Investment?
Speech Recognition software such as Dragon NaturallySpeaking has been on the market for some time now and has received a varied response from user’s across a variety of vertical markets such as in the Legal and Medical industries. The public has always had an interest in and a fascination with software that can turn your voice into text, but beyond that novelty, can the software really improve a busy professional’s productivity or provide a significant cost savings and return on investment? Well, if you answer yes to either of the following questions, then you may be surprised to find that the software can not only do both, but pays for itself in a much quicker timeframe that you might think!
Do you spend any amount of your business day typing? Whether it’s sending emails, drafting business correspondence, typing into a customer relations management software, or even an Electronic Medical Record program, your productivity is still limited by how fast you can type. The average individual types around 40 words per minute and even expert typists top out at around 120 words per minute. What if I told you that speech recognition software could allow you to produce text at 160 words per minute, with no special skill required other than your plain old, every day speaking voice? What would it mean to your workday if you could be two, three or even four times more productive? What could you do with an extra hour or two, each and every day?
Do you dictate as part of your daily routine whether you are in the legal, medical, law enforcement or other professional industry? Is your dictation then converted into typed text by a third party, whether it’s an assistant or transcriptionist? Operating costs are a concern for any business or company with a tight budget and the time and money spent documenting vital information, whether it’s a legal brief, a patient’s history and physical or a criminal report, impact operational expenses. What if the amount of time spent on this process could be significantly reduced? What if the costs associated with this documentation process could be reduced by as much as 30%? What would that mean to your office’s bottom line every year? Using speech recognition to automatically create documentation that requires little if any proofing or editing, frees up valuable time for staff as well as provides a substantial cost savings.
The possible productivity gains mentioned in this article are just the tip of the iceberg when it comes to what the latest versions of speech recognition software can do for the busy professional. With a variety of editions available with feature sets suited to professional industries such as Legal and Medical, it is well worth a company’s time and money to research how speech recognition could dramatically improve the way they do business.
Insurers press doctors to file more claims electronically
From article posted on – The Hill – Healthwatch, February 5, 2013
The number of claims submitted and processed electronically has almost doubled over about the past decade, according to data released Tuesday by America’s Health Insurance Plans (AHIP).
AHIP said electronic claims rose from 44 percent in 2002 to 94 percent in 2011.
But AHIP pressed doctors to file claims more quickly, saying 54 percent of paper claims were filed more than 30 days after the service was provided. Only 16 percent of electronic claims were filed after 30 days, AHIP said.
“This survey demonstrates that health plans are playing a leadership role in improving claims processing,” AHIP President and CEO Karen Ignagni said in a statement. “Increasing the percentage of claims submitted and paid electronically will reduce paperwork, improve efficiency and help bring down costs.”
HIPAA Changes Could Create New Bureaucratic Burdens
From January 23, 2013 article by Michelle McNickle, Associate Editor of InformationWeek Healthcare
Modifications to HIPAA may take the focus off patients and pile on administrative work.
Changes coming to the HIPAA Privacy and Security Rule mean added administrative work, and they could mean additional reporting, said Lisa Sotto, head of Hunton & Williams’ global privacy and data security practice in an interview with InformationWeek Healthcare.
The Department of Health and Human Services recently announced what Office of Civil Rights (OCR) director Leon Rodriguez called “sweeping changes” to HIPAA that will strengthen the OCR’s ability to enforce HIPAA.
The changes, also known as the final omnibus rule, are broken down into four parts, HHS explained in a PDF document. Among the four parts are modifications to the HIPAA security rule first proposed in July 2010; changes to HIPAA enforcement to incorporate the tiered civil monetary penalty structure provided by the HITECH Act; a final rule on breach notification for unsecured protected health information under the HITECH Act; and a final rule modifying the HIPAA Privacy Rule as required by the Genetic Information Nondiscrimination Act (GINA) to prohibit health plans from using or disclosing genetic information for underwriting purposes.
The final rule focusing on breach notifications creates a “significant shift” in the new issuance from a harm-based standard to a focus on the probability that data is compromised in any data leak, Sotto said. The interim final rule had used a harm threshold that meant companies had to notify patients of a data loss if there was a significant risk of patient harm. That threshold has been replaced by a presumption that data privacy is compromised when data is exposed, unless the organization can demonstrate there was a low probability that personal health information had been compromised based on a set of factors.
“The focus on harm to the individual and any injury the individual may suffer has been eclipsed by the question of whether the PHI has been compromised,” she said. OCR considers this a more objective standard, but “I like the idea of the assessment focusing on the individual, rather than thinking about a breach in a vacuum without strong reference to the individual,” Sotto said.
The new rules also could force organizations to know how data is handled by business partners. A “business associate” amendment was part of HITECH when it was first enacted in 2009. What’s changed as part of the first rule, said Sotto, is that HHS has imposed an obligation “all the way downstream” to every subcontractor that has access to PHI. This results in “some very long chains of custody for data,” she said.
“There’s a huge bureaucratic burden that’s about to hit because every business associate agreement in place needs to be amended, and a huge wave of businesses in the U.S. will be hit with business associate-like agreements because they’re subcontractors,” said Sotto. “They could be the subcontractor of a subcontractor to the business associate of a covered entity.” IT organizations will have to let all their subcontractors know they’re directly responsible for HIPAA compliance, she said. “This is an enormous administrative burden that’s about to happen,” Sotto warned.
HIPAA Final Rule Raises Fines for Non-Compliance
By Dom Nicastro, HealthLeaders Media, January 22, 201
The HIPAA omnibus final rule released by the Department of Health & Human Services January 17 will cost hospitals some time and money in regulation analysis, training, and policy revision, but shouldn’t break the bank, healthcare leaders and privacy and security experts say.
The HIPAA “mega rule,” so-called by some in the industry, represents the largest set of modifications to the HIPAA privacy and security rules to date.
“The new law needs to be analyzed and will have some impact on current processes, although they appear after my high level review to be expected and minor in nature,” says Chris D. Van Gorder, FACHE, president and CEO of Scripps Health in San Diego.
“There will be costs to Scripps to analyze the regs, revise policies, revise and distribute the Notice of Privacy Practice (NPP), and to revise our standard Business Associate agreement if legal determines that is necessary and get our BA’s to sign the new version.”
The final omnibus rule enhances a patient’s privacy protections, provides individuals new rights to their health information, strengthens the government’s ability to enforce the law, and requires updates to business associate contracts.
The rule, required by the Health Information Technology for Economic and Clinical Health (HITECH) Act signed into law in February of 2009, is enforceable beginning September 24. It holds accountable third-party subcontractors who use and disclose PHI to HIPAA rules and penalties.
Regulation review
Healthcare leaders must direct someone, most likely privacy and security officers, to perform a thorough review to identify high level process and policy changes necessary for compliance with the new rule.
“I think for CEO and CIO, the first step is to ensure your privacy and security officers get right on this and digest it,” says Kate Borten, CISM, CISSP, former head of information security at Massachusetts General Hospital in Boston and the president of The Marblehead Group, a healthcare privacy and security consultancy in Marblehead, MA. “They are your internal experts, and this is a big part of their role.”
Organizations charged with HIPAA compliance must understand now that all signs are pointing to increased enforcement, adds Brad M. Rostolsky, partner in the Philadelphia office of the law firm Reed Smith, LLP.
“The ‘good old days’ of voluntary compliance and ‘slaps on the wrist’ seem to be a thing of the past,” Rostolsky says. “As a result, it’s important that regulated businesses, from the top down, are seen to have buy-in to HIPAA compliance efforts. HIPAA privacy and security officers should be involved at the highest levels of compliance planning.”
Increased penalties for noncompliance
HHS made official in the omnibus rule increased civil monetary penalties ranging from $100 in the “did not know” category to $1.5 million in the “not corrected” category.
The factors that will be considered when determining civil money penalties for non-compliance have expanded significantly, says Rebecca Herold, CISSP, CIPP/US/IT, CISM, CISA, FLMI, partner in Compliance Helper and CEO of The Privacy Professor of Des Moines, IA.
“To date, the factors really only involved the implementation of controls, as required by HIPAA, and any levels of ‘willful neglect’ involved in the associated situations,” Herold says. “So pretty much the sanctions applied were based upon the preventive actions that were in place, or lacking. Now there are significant additional considerations: the impacts of the breach will be considered.”
What will HHS review in terms of the extent of breaches in the new omnibus rule?
- Number of individuals affected
- Time period during which the violation occurred
- Nature and extent of the harm resulting from the violation, consideration of which may include but is not limited to:
- Whether the violation caused physical harm
- Whether the violation resulted in financial harm
- Whether the violation resulted in harm to an individual’s reputation
- Whether the violation hindered an individual’s ability to obtain healthcare
“I find the consideration of harm to an individual’s reputation to be of particular interest, since that has been comparatively hard to prove in past court cases,” Herold says. “However, this particularly points to the need to keep patient information off social media sites, since that has been a source of many breaches involving patient information.”
Action steps for C-Suite
Though enforcement will not come until the fall, CEOs must know the changes will require actions that go beyond the simple checklist approach to compliance that has been par for the course over the past several years, Herold says.
“Those responsible for compliance must be able to implement, and maintain, controls that will fit the organizational environment, and that will be incorporated into every-day work activities,” she adds.
Healthcare leaders, she says, should consider the following compliance action steps:
- Support more training, and significantly more ongoing awareness communications than most CEs and BAs currently are providing
- Encourage more oversight of BAs. This means better tracking of the BAs.
- Update the organization’s breach-response plans. The rule eliminates the “harm threshold” provision, which allowed covered entities and business associates to avoid breach notification if they determined themselves a breach would not cause harm to an individual. HHS now calls for covered entities and BAs to assess the probability that the PHI has been compromised instead of assessing the risk of harm to the individual.
- Establish a way to monitor compliance and risks on an ongoing basis, along with metrics/statistics, to most quickly identify when problems areas with regard to security and privacy emerge
- Implement better PHI safeguards by CEs and all others (BAs and their subcontractors) which will lead to fewer breaches and also help to ensure more accurate PHI
- Assign a person/team responsibility for doing a gap analysis between current practices and the new requirements
- Identify all BAs and make sure they know the new requirements, and provide some type of evidence to demonstrate their compliance activities
- Plan to provide an awareness communication about the upcoming changes to personnel as soon as possible, and then plan a training session with all personnel sometime in the near term (e.g., within the next month or two; by the March 25 effective date would be ideal).
- Implement ongoing compliance monitoring actions, with associated metrics.
“From my perspective, a covered entity or business associate’s most important reaction to the final rule is to make sure that it has recently undertaken a Security Rule risk analysis,” Rostolsky says. “Although the final rule includes many areas of significant change, the Office for Civil Rights (the HIPAA enforcer under HHS) is clearly viewing the failure to conduct a risk analysis as a key trigger to enforcement action.”
Further, BAs, covered entities and now those subcontractors of BAs who use and disclose PHI on behalf of BAs must update business associate contracts within 180 days from the date the rule is published in the Federal Register (January 25).
“The HITECH rules already addressed this, and enough guidance was provided in HITECH and within that next year so that Scripps has already revised our standard BAA,” Van Gorder says. “We might expect that some smaller BAs may go out of business or change their business if they are un-willing or unable to comply with the HIPAA rules, particularly the Security Rule.”
A major rule regarding HIPAA privacy is still due: The accounting of disclosures rule that will greatly impact patients’ rights to request records and potentially give them more access to who viewed their records through an “access report.”
“I would share with a board that it doesn’t seem these final rules are creating too many ripples in the HIPAA pond,” says Frank Ruelas, MBA, principal of HIPAA College in Casa Grande, AZ.
“But be aware that one of the big questions about whether patients’ will have the right to an access report has yet to be answered. That is one area I see as one of the most challenging and ambitious HIPAA requirements to be decided upon.”
When it comes to patient records, doctors guilty of the old copy-paste
January 10, 2013 article on CNET.com by Elizabeth Armstrong Moore
A new study finds the majority of doctors copying potentially out-of-date information from previous notes and other documents and pasting them into patient progress reports.
Ah, the old copy/paste. Such a handy keyboard shortcut for such a wide range of applications. But would you want your doctor using it while maintaining your oh-so-personal and unique-to-you medical records?
Because chances are good that your doc does, according to new research out of Case Western Reserve University School of Medicine. Excuse me while I take a moment to summarize, rather than copy and paste, some key findings from the research.
Assistant professor of medicine and lead author Daryl Thornton and his team scrutinized 2,068 electronic patient progress reports at an ICU in Cleveland. Some 62 residents and 11 attending physicians had their gloved hands in these documents over the course of five months as they updated the files of 135 patients.
Thanks to software typically used to detect plagiarism, the researchers found that 82 percent of residents’ notes and 74 percent of attending physicians’ notes contained material that had been copied from previous records or other documents. And the offending “material” was not just a phrase or two; at least 20 percent of the records had been inserted from elsewhere.
While the copying behavior may range from harmless time saving to the insertion of downright erroneous information, the researchers readily admit that they set out to find prevalence of copying and did not delve into why the physicians did this or what effect, if any, this behavior has on actual patient care.
And now, if I may be so bold as to copy from the study itself, the researchers conclude: “Further studies should focus on further elucidating the factors influencing copying in the ICU and the effects of copying on patient outcomes.”
For now, if you’d like to catch your own doctor in the act, simply request your medical records and see if they are current and appear to be about you. You should be able to see most of the notes, though in some states, such as New York, the physician can deny access to his or her “personal notes and observations.”
When To Ignore That Mobile Health App
By Paul Cerrato InformationWeek – HealthCare. January 03, 2013
Much has been written about the power of mobile technology to transform patient care, and many innovative developers have produced apps that really do move us forward. But sometimes our enthusiasm can blind us to the trash that people continue to download onto their tablets and smartphones.
A case in point: iSAD, an app that allegedly reduces the signs and symptoms of Seasonal Affective Disorder (SAD), a serious form of depression that strikes during the winter months. While there’s solid evidence to show that light therapy can improve this condition, there’s no way an app that lights up your cell phone will have any effect on the disorder. A 3G iPhone, for instance, can generate only 200 lux of light, but SAD patients need at least 2,000 lux to experience any benefits.
Apps that claim to benefit patients suffering from clinical depression join a long list of other scientifically groundless online tools for weight loss, stress management and the like, a topic I recently addressed in a slideshow titled “Is That Healthcare Website Making You Sick?”
Unfortunately, consumers aren’t the only ones who need to be cautious. Clinicians may be tempted to load an app that on first blush will make their jobs easier, such as a smartphone app that lets them view X-rays — not a good idea considering the fact that the screen is simply too small. Some experts even recommend against viewing medical images on an iPad because of its size and relatively poor resolution.
All this criticism begs the question: How do you choose an effective mobile health app? The best approach is to use the same criteria that discriminating physicians have been using for years when evaluating new medical treatments. Here are three criteria worth applying:
–Look for controlled clinical research that supports the app. Many developers haven’t done enough homework or linked up with a medical school faculty that can test their product, but some have. The WellDoc Mobile Diabetes Management app comes to mind because the company has done research to prove its value. Similarly, apps classified as medical devices by the FDA require rigorous testing. AirStrip’s fetal monitoring and cardiac monitoring apps fall into that category.
–Demand physiological plausibility. The claims made for any app must, at the very least, be consistent with the laws of physics and known facts about how the body functions. Granted, for a buyer to make a judgment call on physiological plausibility sometimes requires in-depth knowledge of health science. If you feel you’re out of your comfort zone, turn to a medical expert you trust.
–Don’t rely too heavily on anecdotal evidence. Testimonials from famous athletes and actors turn heads, but they rarely prove that a treatment protocol, or a mobile app, can cure your baldness or lift your depression.
That said, let me take a moment to contradict myself. The history of medicine is filled with innovative scientists who developed invaluable treatments that work but that were initially condemned as snake oil. No doubt there are health apps on the market that fall into this category. They may have no clinical research to support them and don’t make a whole lot of sense conceptually — but they still work.
But such unappreciated geniuses and their apps are few and far between. The vast majority of apps that find their way onto your radar screen call for a healthy dose of skepticism.
Health Reform May Be Headed Back to Supreme Court in 2013
January 1, 2013, Interview by Jason Kane, PBS NewsHour
Should old acquaintance be forgot and never brought to mind? Maybe not for the Affordable Care Act.
Looks like 2013 will include many of the characters who made 2012 such a nerve-racking year for the health care reform law — everyone from state-level leaders hoping to prevent its full implementation to Supreme Court justices deciding the law’s fate. The nation’s highest court may have upheld a central pillar of the law last summer — the so-called “individual mandate” that most Americans either purchase health insurance or pay a fine — but that doesn’t mean the rest of the ACA is free from debate.
Questions are slowly percolating through the lower courts — with some possibly headed toward the Supreme Court — about contraception coverage, the Senate’s ability to “originate” a tax and the legality of the online insurance marketplaces known as exchanges.
For an overview of where all these new challenges stand, we turn once again to Marcia Coyle of the National Law Journal.
NewsHour: Marcia, how do these new lawsuits relate to the Supreme Court’s decision last summer?
Coyle: The justices last June decided two core questions about the law’s constitutionality. A 5-4 majority held that the minimum insurance requirement, the so-called individual mandate, was a valid exercise of Congress’ taxing power, but not its commerce clause power. A 7-2 majority also held that the expansion of the federal-state Medicaid program for the poor and disabled unconstitutionally coerced the states into participating in the expansion by threatening to withhold states’ Medicaid funds. But the justices’ decision in that case — National Federation of Independent Business v. Sebelius — did not stop lawsuits challenging other aspects of the health care law.
NewsHour: What types of lawsuits are now working their way through the courts?
Coyle: There are several types. The largest group, about 42 cases, challenge a federal regulation under the law that requires all group health plans and health insurance issuers, unless grandfathered or otherwise exempt, to cover preventive care and screenings for women. The Department of Health and Human Services issued an interim rule in August 2011 that exempted certain organizations with religious objections to contraception. A number of religious colleges and other employers sued, claiming the contraception mandate violates their deeply held religious beliefs.
NewsHour: Have any of those lawsuits been successful?
Coyle: A number of the lawsuits have been dismissed as premature because the Health and Human Services Department interim rule created a safe harbor from enforcement of the contraceptive coverage requirement for employers with religious objections, which remains in effect until the first plan year that begins on or after August 1, 2013. The department also said it intended to “develop and propose changes to these final regulations that would meet two goals”: providing contraceptive coverage without cost-sharing to covered individuals and accommodating the religious objections of nonprofit organizations. Two notable developments occurred in December, one of which may lead directly to the Supreme Court.
The U.S. Court of Appeals for the 10th Circuit on Dec. 20 denied a request for an injunction to halt enforcement of the contraception mandate in a case brought by Christian-owned and operated Hobby Lobby craft stores. The family owners claimed they had no moral objection to the use of preventive contraceptives and would continue covering preventive contraceptives for their employees. However, they said their religious convictions prohibit them from providing or paying for abortion-inducing drugs, the “morning-after” and “week-after” pills. The federal court held that the religious burden on them was “indirect and attenuated.”
Their lawyers went to the Supreme Court for an injunction to block enforcement of the contraception coverage mandate while they pursued their court challenge. On Dec. 26, Justice Sonia Sotomayor, who handles emergency requests from the 10th Circuit, denied the injunction, explaining that Hobby Lobby did not meet the rigorous standard for this type of court order. She said Hobby Lobby could seek Supreme Court review after its lower court appeals were finished, if it wished to do so.
Just two days later, another federal appeals court — the 7th Circuit — temporarily barred enforcement of the contraception mandate against an Illinois construction company whose Roman Catholic owners also claimed it violated their religious beliefs.
Hobby Lobby and the Illinois company are for-profit businesses. The Obama administration has argued that the Religious Freedom Restoration Act, relied on by the two companies in their lawsuits, does not insulate secular, for-profit businesses from this regulation.
Both cases may reach the Supreme Court in 2013.
The District of Columbia federal appellate court put on hold lawsuits by two religious colleges challenging the contraception insurance mandate. That court said the lawsuits will be held in abeyance until the federal government makes good on its promise to issue a final new rule that exempts employers like the religious colleges. The court also ordered the government to provide it with status reports every 60 days.
NewsHour: Do those lawsuits have the potential to strike down the health care law?
Coyle: No. They raise important issues, but do not involve a central issue of Congress’ authority to enact the law.
NewsHour: What other lawsuits are percolating in the lower courts?
Coyle: There is a constitutional challenge involving the process used by Congress to enact the health care law. The conservative Pacific Legal Foundation has sued, arguing that if, as the Supreme Court held, the individual mandate is a tax, then it is an unconstitutional tax because it originated in the Senate and not in the House of Representatives as required by the Constitution for bills raising revenue. This lawsuit is based on the Constitution’s origination clause. The challengers say the Senate inserted the health care law’s provisions into a “shell” bill, a House-passed bill whose contents were stripped and replaced by the health care amendments. Some court scholars see this lawsuit as a long shot because courts in the past have given Congress a lot of deference with legislation passed in a similar fashion.
NewsHour: What are the lawsuits involving the insurance exchanges?
Coyle: There is a tax case brought by the attorney general of Oklahoma that could create problems for the federal government in the operation of those exchanges. The attorney general challenges a recent IRS rule which extends tax credits and subsidies to the purchase of health insurance in federally operated health insurance exchanges created in states that have refused to establish their own exchanges. The federal law, according to the lawsuit, authorizes those credits and subsidies only to state-operated exchanges. Oklahoma, which has refused to create an exchange, says the IRS rule violates state sovereignty.
NewsHour: When do you think the Supreme Court may look at some of these cases?
Coyle: Any of the losing parties in these lawsuits can petition the Supreme Court for review once their case is finished in the lower courts, and that includes the federal government. But petitioning the Court is no guarantee that the justices will agree to take any of the cases. A case raising religious objections to contraception coverage may have the best chance of eventually being reviewed, but we will have to wait and see.
Not One Successful EHR System In Whole World
From December 18, 2012 article on InformationWeek HealthCare
While federal health IT officials were touting the perceived successes of their efforts to increase physician usage of electronic health records (EHRs), one longtime advocate of EHRs was criticizing the whole direction of health IT policy.
“In my opinion, there is not one successful EHR system in the whole world,” said C. Peter Waegemann, who founded and ran the Boston-based Medical Records Institute from 1984 to 2009. “User friendliness, usability, and interoperability are not there,” he added in an interview with InformationWeek Healthcare.
He defined a successful EHR as one that is fully interoperable. “We have been focusing too much on documentation [for the purpose of reimbursement],” he said. This point has not been lost on the Obama administration, which has warned providers about using EHRs to “game the system.”
Still, Waegemann believes the administration has not been aggressive enough with its $27 billion federal Meaningful Use EHR incentive program, based on published rules for Stage 2 and early recommendations for Stage 3. “MU2 and MU3 are just small steps. They rely on old technology,” Waegemann said.
He noted that a number of leading EHR systems are written in the MUMPS programming language that originated at Massachusetts General Hospital in the late 1960s. Meaningful Use also relies on outdated standards such as version 2.x of Health Level Seven International’s messaging standards rather than the more recent version 3.
According to Waegemann, too many organizations with EHRs still have paper forms and few EHRs are integrated with personal health records (PHRs).
“What we need is an EHR that is only an accessory to ‘e-care,’” he said. Waegemann defines e-care as a patient-centric system in which technology serves as an adjunct to make healthcare more efficient. In his opinion, an EHR should include clinical decision support, the capture of clinical information at the point of care so the physician does not have to key in data, and automatic creation of documentation.
Meaningful Use does require physicians and hospitals to give some patients access to their records, but today’s patient portals are “passive,” according to Waegemann, in that individuals often are not able to enter their own information. It’s not a personal health record, with patients truly in control, Waegemann contended.
He also said that the U.S. has wasted hundreds of millions of dollars on what first were called community health information networks (CHINs), then regional health information organizations (RHIOs), and more recently, health information exchanges (HIEs). Instead of regional networks, healthcare should look at point-to-point interoperability through standards.
“We need to have a totally different approach,” Waegemann said. “What we need is an app that links anyone in personal care, from physical therapist to chiropractor to pharmacist.”
Waegemann’s Medical Records Institute put on an annual conference called Toward an Electronic Patient Record (TEPR) for 25 years. In the face of dwindling interest in TEPR, Waegemann reshaped the organization into the mHealth Initiative in early 2009, putting the focus on mobile technology in healthcare. The experiment lasted about three years until he quietly shut that entity down.
Electronic Health Records Breed Digital Discontent For Some Docs
From December 4, 2012 article in the Kaiser Health News
Two years and $8.4 billion into the government’s effort to get doctors to take their practices digital, some unintended consequences are starting to emerge. One is a lot of unhappy doctors. In a big survey by Medscape this summer 38 percent of the doctors polled said they were unhappy with their electronic medical records system.
Dr. Mary Wilkerson is one of those doctors. Her small family practice in Denver made the leap to an electronic health record five years ago, with some pretty high expectations.
“We were told by sales people that we would make more money, because we’d be more efficient, and you’d be able to see more patients,” says Wilkerson. “We’d be able to bill faster, get the money in the bank at the push of a button. And none of that panned out.”
Instead, Wilkerson’s practice found that electronic records actually slowed things down, and the doctors could see fewer patients.
“Within six months of our purchase, one of the partners just did not like it at all, did not like dealing with the computer, and actually left the practice, and we’d hoped she’d contribute to the loan that we’d taken out” to pay for the electronic system, says Wilkerson.
Wilkerson’s problems with the system are a stark contrast to the experience of other doctors who have embraced electronic records and patients who have good reviews of them, too.
Marina Blake of Denver is one of those patients. Blake uses a lot of health care, and she likes that the specialists she sees can all call up the same health record that her primary care doctor uses. She can also call up her own record anytime.
“It does add definitely a layer of customer service to my experience that is really awesome,” says Blake, who belongs to a large health care system that uses electronic records. “For me it’s part of being an educated consumer. If I have more information, then I can ask better questions.”
The federal government wants every patient to see the same benefits from electronic records Blake does. It’s offering doctors and hospitals up to $63,000 per physician to go digital.
But Wilkerson’s practice didn’t get much government money, because payments to go digital are tied to seeing a lot of Medicare patients, which Wilkerson and her partners didn’t do. They took out a loan because it’s common for physicians to pay $10,000 or more each for digital records systems. So losing income from not being able to see as many patients was hard on Wilkerson’s practice. The expense and the hassle was part of the reason that she and her partners ultimately decided to sell their practice.
he American Academy of Family Physicians supports the switch to digital but acknowledges that it has been difficult for many doctors.
“Right now we’re in a transitional time. Transitional times are tough,” says Dr. Jeff Cain, president of AAFP.
Cain says electronic records improve care, and notes that Medicare will start cutting payments to doctors who haven’t gone digital starting in 2015. He’s somewhat critical of the government’s strategy.
“The challenge for the family doctor with the carrot-and-stick approach Medicare’s using is, the carrot’s kind of hard to get to,” says Cain.
For its part, Medicare is now worried that part of the digital efficiency it’s encouraging is also making it easier for doctors to generate bills, and charge it too much. Doctors say it should be no surprise that systems designed to catch things like medication errors are also catching missed opportunities to get paid.
That unanticipated argument over billing is playing out as federal payments begin to ramp down. They’re being offered until 2021, but the amount available gets smaller every year.
Merry Christmas and Good Will to All Mankind!
Hello everyone, Matt LaMond here with TranscriptionGear.Com. It is that time of the year again where we all begin preparing for the holidays. Well we here at TranscriptionGear.Com wanted to wish all of our friends and fans a very Merry Christmas and good will to all mankind! This year we decided to make an animated christmas card for your viewing pleasure. Click the image below to open our present to you. We all hope you enjoy and have a very happy holidays during the end of 2012 and we look forward to seeing all of you in 2013!
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