SMARTDC Monthly Newsletter- A Timely Summary of Your IT News

SMARTDC Releases EHR version 3.1

Fort Lauderdale , FL – December 20, 2010 – SMARTDC, Inc. announced today the general availability of its 3.1 EHR (Electronic Medical Record) product. SMARTDC provides a pain free path for transcription customers to migrate to electronic charts. The SMARTDC suite of services – transcription, billing, and EHR – provides a one-stop solution for small to medium practices. Additionally, Congress recently extended the amount that small businesses may write-off for capital expenditures to $134,000 ( See below on this IRS benefit for your EHR purchase in 2010 ). “This latest release of our EHR product includes an improved, efficient and easy to use document encounter notes and along with the products ability to capture charges. With industry leading innovations such as in-line editing and diagnosis-driven templates, SMARTDC offers a unique architecture that is ideally suited for a small practice. Of more importance to our thousands of transcription customers is that this 3.1 release seamlessly integrates with our dictation services featuring one dictation to fill all sections. In fact, current transcription clients can upgrade to our EHR with minimal disruption to their business” states SMARTDC President, Nandip Kothari.

To experience a live demonstration of our EHR, please contact directly:
Mr. Kevin Wolfe,
Vice-President of Sales.
Cell: 414-418-6695 or E-Mail KWolfe@smart-dc.com

EHR reimbursement registration opens Jan. 3

Registration for the Medicare and Medicaid electronic health-record system incentive programs opens Jan. 3 for hospitals, office-based physicians and other providers, HHS and the CMS announced. “With the start of registration, these landmark programs get under way, and patients, providers and the nation can begin to enjoy the benefits of widespread adoption of electronic health records,” CMS Administrator Donald Berwick said in a media statement. “CMS has many resources available to help providers register and participate, and we look forward to working with eligible professionals and eligible hospitals to facilitate the process, beginning on January 3rd and going forward.”

“It's time to get connected,” added David Blumenthal, head of the Office of the National Coordinator for Health Information Technology at HHS. Blumenthal said the ONC's official list of certified EHR systems and modules of systems has more that 130 products from which providers may choose.

Under the Medicare programs, both hospitals and office-based providers must use a certified system according to CMS meaningful-use guidelines for 90 consecutive days within the first year of the program to qualify for reimbursements under the American Recovery and Reinvestment Act's incentive programs. The Medicare program follows the federal fiscal year, which began Oct. 1. Other key Medicare dates, according to the statement, include: an April 2011 start for the receipt of attestations from providers that they have met the meaningful use requirements; and first Medicare incentive payments for those early qualifiers could begin to flow by May 2011.

With Medicaid, providers are not required to meet meaningful use criteria during the first year of the program, but rather need only to adopt, implement or upgrade to a certified system during the first year of eligibility to received payments under the stimulus program. Not all state Medicaid programs are ready to register providers but these 11 are: Alaska , Iowa , Kentucky , Louisiana , Oklahoma , Michigan , Mississippi , North Carolina , South Carolina , Tennessee , and Texas . In February, registration will open in California , Missouri and North Dakota . Several will be ready to make their first payments under the program by late January or early February. Other states may not launch their Medicaid programs until spring or summer of 2011, according to the HHS and CMS statement.

Study: EHR alert system improves doctor performance

An electronic health system that alerts physicians with a yellow light when problems exist with a patient's care is being used by doctors at Northwestern Medicine. The system goes one step further by tying docs' responses to the alerts to quarterly performance reports. Forty primary care physicians at Northwestern Medicine were part of a study which showing that, after one year of using the new system, it had significantly improved doctors' performance and the healthcare of patients with chronic conditions such as diabetes and cardiovascular disease. It also boosted preventive care in vaccinations and cancer and osteoporosis screenings.

Among the improvements: the number of heart disease patients receiving cholesterol-lowering medication rose from 87 to 93 percent, pneumonia vaccinations increased from 80 to 90 percent, and colon cancer screenings from 57 to 62 percent. "The gains are modest, but if you are already at 90 percent and go to 94 percent, that's important," said lead author Stephen Persell, MD, an assistant professor of medicine at Northwestern University Feinberg School of Medicine and a physician at Northwestern Memorial Hospital. "It helps us find needles in the haystack and focus on patients who really have outstanding needs that may have slipped between the cracks," said Persell, who is also a researcher in the division of general internal medicine. "Quality healthcare is not just about having good doctors and nurses taking care of you," he added.

"It's having systems in place that make it easier for them to do their jobs and insure that patients get what they need." To create the program, researchers used existing tools already available in a commercial electronic health record system. They integrated the health records with performance reports and paid close attention to the quality of information fed to physicians. The system includes an unobtrusive yellow light on the side of a doctor's computer alerts them to a message that there is a problem with a patient's care. When the doctor clicks on the light, they may learn, for example, that a patient who has congestive heart failure hasn't gotten his or her recommended pneumonia vaccine, or perhaps was taken off beta-blockers during a recent hospitalization and needs to start them again.

"The pieces of this system aren't new, but putting them together in a comprehensive way is new," Persell noted. "If you put these things together in a smart way, then electronic health records are powerful tools for quality of care." "What matters is how you use the electronic health records, so they make your job easier rather than act as a source of constant annoyance and false alarms," Persell said. "By showing only things that appear to be out of order, we are trying not to overwhelm the physician. If doctors get inaccurate alerts saying do this, do that, then they will ignore them." Essential to the success of the program say study authors is that they system doesn't waste doctors' time, isn't annoying and is tied to performance reviews. "You can't shove it in doctors' faces, or they walk away from it," Persell noted. "We used reminders that were not intrusive, but were still effective because doctors had faith that the data was accurate and they could enter data to make it more accurate."

David Baker, MD, senior author and chief of Northwestern Medicine's general internal medicine divison, added, "we wanted physicians to feel ownership of this. For this to work well, they have to view the alerts and reporting system as their personal quality improvement tools." Doctors' interactions with the reminders were tied to quarterly performance reports based on their treatment of chronic disease and preventive care quality measures. They were willing to use the electronic tools, Persell believes, because they were regularly being reminded of their performance, and the tools were helping them improve it.

When a recommended treatment is not the medically right choice for a patient, the doctor is able to enter that information so that they won't be penalized in performance reports for not prescribing it. The study is published online in the journal Medical Care and in the February print issue.

Healthcare iPad Deployment to Approach 70% in 2011

The rising numbers of iPad point-of-care applications are accelerating its use by physicians, finds Healthcare Information and Management Systems Society survey.

Results from a survey of nearly 950 Healthcare Information and Management Systems Society (HIMSS) members indicate that iPad deployments are accelerating in large part due to the mobile device's compelling point-of-care applications and uses. Conducted October 26 during an online webinar cosponsored by HIMSS and BoxTone, a mobile service management (MSM) company, the survey's results were released earlier this month. Data showed that nearly 70% of the attendees were from hospitals or healthcare organizations with more than 1,500 employees, and 15% of attendees were executive-level staff or physicians.

More than 25% of the HIMSS respondents plan to deploy the iPad and other iOS devices immediately and nearly 70% plan to deploy the devices within the next year. One-third of respondents identified point-of-care applications -- including lab order visualization and results, clinical decision support, and medical image viewing applications -- as top priorities, while 18% identified general administration, including billing, coding, and claims applications, as top priorities. Nearly 75% identified secure configuration and deployment as the number one iPad IT management challenge, and 53% identified mobile application deployment as a key issue.

Lynne Dunbrack, analyst with IDC Health Insights, said security will remain a top concern for healthcare CIOs, especially if clinicians bring in their own devices to access the hospital's healthcare information systems, such as Electronic Health Records (EHRs) and computerized physician order entry (CPOE) systems. "As more patient information is moved into EHRs and made accessible both inside and outside the organization via a range of devices, including mobile devices and tablets, the risk of privacy breach rises. Organized deployment and virtualized clients will help to mitigate this concern," Dunbrack said. Dunbrack also noted that the iPad, which has a sleek design, an intuitive user interface, and a large screen (relative to a smartphone), is becoming increasingly popular among clinicians. As the iPad gains traction among healthcare providers, EHR vendors will develop bidirectional integration between their EHR applications and clinicians' mobile point-of-care devices such as smartphones and tablets.

EHR Systems Workflow Effects Vary by Physician Specialization

Electronic health record use has varying effects on productivity depending on medical specialty, according to a University of California-Davis study , Modern Healthcare reports. The study -- led by Hemant Bhargava, associate dean and professor of management and computer science at the UC-Davis Graduate School of Management -- monitored the implementation of an EHR system in six primary care practices from 2003 to 2006 (Conn, Modern Healthcare , 12/17).

Data were collected on about 100 physicians in three primary care categories:

• Internal medicine
• Family; and
• Pediatrics.

Key Findings

Researchers found that an EHR system's impact on physician productivity varied by specialty after health care providers became fully acclimated to the systems. According to the study, initial implementation of an EHR system resulted in a productivity drop of 25% to 33%, which researchers expected. However, in the months that followed, internal medicine units saw an improvement in workflow, but pediatricians and family physicians experienced slight drops in productivity. Bhargava said a "one-size-fits-all" approach does not work with EHR systems.

Reasons for Variation