Mission Critical
As EMR advisors to many Independent Physicians Associations, nothing is more important to us than the success of our physician clients.
In the ever-changing world of healthcare, we are your advocates, assisting you in the selection, implementation, training, service and support of the technology required for improved patient care and relief of margin compression. We take a holistic approach to assisting your medical practice. In addition, we include change management, work flow analysis, financing, revenue cycle management and more. We are advocates of bilateral performance–success breeds success–failure is not an option.
The difference at HIT is not just our people, our training, our technology or even our solution-based creativity. The difference is our philosophy of leadership that defines our work and the relationships that we build. Your success is our priority!
In the ever-changing world of healthcare, we are your advocates, assisting you in the selection, implementation, training, service and support of the technology required for improved patient care and relief of margin compression. We take a holistic approach to assisting your medical practice. In addition, we include change management, work flow analysis, financing, revenue cycle management and more. We are advocates of bilateral performance–success breeds success–failure is not an option.
The difference at HIT is not just our people, our training, our technology or even our solution-based creativity. The difference is our philosophy of leadership that defines our work and the relationships that we build. Your success is our priority!
The Challenge
Medical practices are under extreme pressure to improve quality of care and become more efficient. The challenge is to find and apply technology (automate) that is:
• Sufficiently robust to:
• Will qualify for stimulus reimbursement
• Be most applicable to the technology needs of the practice.
• Sufficiently robust to:
- Achieve meaningful use as determined by regulators
- Allow clinical trials to increase revenue
- Strongly comply with HIPAA to hedge that newly increased liability
• Will qualify for stimulus reimbursement
• Be most applicable to the technology needs of the practice.
Change
Our mantra is “change is good.” We see three factors as critical to the success of an HIT implementation:
- Strong physician leadership,
- Sufficient resources for both physician and staff education, and
- The patience to allow everyone in the practice to overcome the learning curve.
- Engaging the patients as part of the global solution.
- Working with the patients and us to develop a meaningful patient portal
Physician Champion
An enduring axiom about electronic medical record (EMR) implementations remains unchanged: “If no physician champion, then don’t implement”. The physician champion’s role in an EMR implementation is to keenly focus on strategic implementation decisions, education of colleagues on the EMR, process/work flow redesign and on the design, configuration, build and testing of the EMR.
In a recent symposium by Cleveland Clinic, when asked what the greatest problem in implementing and ambulatory EMR, they stated that it was the inability to engage the physician early in the process. This results in a much rougher process in having to redo things which could have been completed properly in the first place with physician involvement.
In our role as advocates we have designed an EMR Readiness Questionnaire/Interview as a tool to engage physician and staff alike so we can work together as a performance driven team to accomplish the common goal. With our support the physician champion can keep everyone in the practice pointed in the same direction and clearly communicate to the entire practice that although increasing efficiency is a major goal in an HIT purchase, at first the practice will have to slow down so that both physicians and staff can gain proficiency in using the software. Then the practice can integrate necessary information from the paper medical record into the electronic system. With our emphasis on training much of the slowdown can be mitigated.
In a recent symposium by Cleveland Clinic, when asked what the greatest problem in implementing and ambulatory EMR, they stated that it was the inability to engage the physician early in the process. This results in a much rougher process in having to redo things which could have been completed properly in the first place with physician involvement.
In our role as advocates we have designed an EMR Readiness Questionnaire/Interview as a tool to engage physician and staff alike so we can work together as a performance driven team to accomplish the common goal. With our support the physician champion can keep everyone in the practice pointed in the same direction and clearly communicate to the entire practice that although increasing efficiency is a major goal in an HIT purchase, at first the practice will have to slow down so that both physicians and staff can gain proficiency in using the software. Then the practice can integrate necessary information from the paper medical record into the electronic system. With our emphasis on training much of the slowdown can be mitigated.
Financing
Healthcare Information Technology, LLC (HIT) has contracts in place with banks as well as healthcare specific hedge funds to bring you the financial facilities necessary for a painless move forward into automation. A needs assessment is available to determine exactly what to expect and exactly what will be needed so that there are no surprises or hardships. These resources include but are not limited to standard loans, leases, lines of credit, working capital and more.
Quality Benefits of an EMR
Assessing data from paper medical records is time-consuming because it involves reviewing information manually—record by record. By contrast, an EMR makes data easily accessible and enables physicians to use their own data to improve quality of care. With efficient electronic access to clinical data, practices can systematically improve the quality of care in a number of areas:
- Improved access to patient records. EMRs improve access to patient information that is both legible and up-to-date. EMRs can provide the physician electronic access to patient records from remote locations whenever needed.
- Improved diagnostic process. The availability of decision support at the point of service fosters a consistent, evidence-based diagnostic process.
- Quicker turnaround times for results of lab tests and imaging studies. Connectivity between practices and the clinical laboratories and imaging centers shorten the time necessary for diagnostic information to reach the practice and the patient. Physicians can initiate therapy more quickly and reduce patient waiting time.
- Streamlined health maintenance and chronic disease management. EMR systems can generate automated appointment reminders for periodic checkups and for monitoring chronic diseases and conditions. Monitoring patient responses to these reminders enables practices to follow up with patients who need medical attention but are not responding to the practice’s automated messages.
- Protocol-based treatment. EMRs have the capability to incorporate treatment protocols so that physicians can track the care of individual patients within an evidence-based framework.
- Reduced medical errors. Intelligent e-prescribing alerts physicians to problems resulting from drug interactions and allergies. It also can help physicians avoid errors caused by the very large number of prescription drugs that have similar names.
- Improved outcomes. The sum of all these individual parts is process improvement that leads to better outcomes. The incorporation of evidence-based protocols, decision support, and e-prescribing into the EMR gives the physician diagnostic and treatment-relevant information during the patient encounter. The tools for improving practice and self-monitoring are immediately at hand.
- Enhanced patient education materials. Practices can customize information packets and Web site referrals for patients so that patients receive essential information about their health at the point of care and guidance from reputable, scientific sources.
Efficiency Benefits of an EMR
The efficiency benefits of an EMR derive from three changes that occur in practices as they move from paper to electronic records:
- The reduction in expenses associated with the management of paper records.
- Significantly more efficient and accurate coding and billing of claims as a result of template-based documentation.
- Redesign of workflow so that practice staff can become more productive users of the practice’s health information technology (HIT) system.
- Real-time access to a patient records from multiple computers and locations, including remote access beyond the office, without physically retrieving a paper chart.
- Multiple people simultaneously accessing a single patient record from multiple locations, improving work flow in some situations.
- Greater time management freeing the provider to increase revenue generating tasks with the confidence that the front desk and “back office” are running smoothly.
Getting Rid of Paper
Typically, practices report a $25 savings per chart by eliminating the supply, copying, printing, and storage of paper charts. Transcription costs generally drop by a range of 50 to 100 percent. Staff efficiency is greatly improved because the time-consuming task of physically moving paper charts around the office is eliminated, and the time needed for ordering and tracking lab tests, imaging studies, and prescriptions is greatly reduced. Put simply, the less time the file has to be touched in any cycle, the greater the incremental bottom line revenue for that patient encounter.
Coding and Billing of Claims
EMRs encourage structured documentation. Commonly, EMRs are able to accommodate user-developed templates to capture services that a practice most frequently provides quickly, accurately, and in detail. In turn, the EMR influences the coding process in two ways:
- Because electronic documentation is structured, it captures the Current Procedural Terminology (CPT) criteria that define levels and types of services more accurately than paper records. As a result, it reduces the number of coding disagreements between practices and payers. In practical terms, the increased accuracy of coding equals a shorter revenue cycle, as payers dispute fewer claims. Also, whenever payers do request additional documentation, the practice easily can send the relevant portions of the patient’s EMR.
- As physicians gain confidence in the accuracy of coding developed on the basis of the EMR, they begin using the full range of E&M codes. In particular, many practices have underutilized the higher-level E&M codes out of fear that payer coding profiles would identify them as “outliers”. But with the more solid EMR documentation in hand, physicians are willing to bill based on the accuracy of their records. This can obviously result in increased revenue. One study of a number of family practices that installed HIT systems found that the combination of more accurate coding and additional office visits (due to increased efficiencies) generated an additional $23,000 per physician in annual revenue.
- Your EMR+PM solution should be able to demonstrate a 98% “1st time” pass rate on the revenue cycle.
Redesign of Workflow
As practices migrate from paper records to EMRs, change is constant. Everybody in the office, including physicians, will perform a major portion of their day-to-day work differently. Much of the economic benefit of HIT derives from the reorganization of daily tasks, as staff and physicians substitute time-consuming, manual processes for technology. The implementation of HIT combined with a major redesign of workflow can reduce practice expenses. According to the MGMA 2008 Cost Survey, less than one quarter of a practices cost are on operating expenses while 78% are related to staff expenses. This necessitates the proper implementation and use of a fully integrated automated system for the practice to compete in today’s environment.
Meaningful Use
The incentive payments under ARRA’s Health Information Technology for Economic and Clinical Health (HITECH) Act are available to physicians who demonstrate “meaningful use” of an EMR. On December 30th, the definition was released (568 pages) which we are reviewing and will clarify in later newsletters. The public has 60 days to comment, the committee then has 30 days to review comments and the definition will be adapted in early April. You will have to qualify each year for the specific year’s stimulus payment and can be summarized in the attached chart. Please keep in mind that this is not final and is based solely off of earlier communication of the committee.
In summary: to demonstrate meaningful use, a provider must be able to:
In summary: to demonstrate meaningful use, a provider must be able to:
- Use certified EMR technology,
- Engage in e-prescribing (physicians must use an e-prescribing system; computer-generated faxes of prescriptions to pharmacies do not qualify),
- Participate in health information exchange in accordance with law and standards, and
- Produce quality reporting measures according to HHS specifications.
- Includes patient demographic and clinical health information,
- Can provide clinical decision support to physician order entry,
- Has the capacity to capture and query information relevant to health care quality, and
- Exchanges and integrates electronic health information with other sources.
EMR Incentives and Penalties
Under the ARRA of 2009 the government will incentivize or penalize “eligible professionals” (MD, DO, OD, DPM, DMD or DC) for either adopting or not adopting respectively a robust Electronic Medical Record system and using it in conformance with Meaningful Use. Eligible professionals do not include hospital based or long term care physicians. The incentives are stimulus dollars that can be “applied for” in the fall of 2010 after showing six months Meaningful Use with first payments due to begin in the 1st quarter of 2011. The penalties (which apply to Medicare Providers – there are no penalties under Medicaid) will begin in 2015. Click here for charts.
PQRI
PQRI is a voluntary program that provides financial incentives to physicians who successfully report on a specified set of quality measures for the services that they provide to patients under the Medicare Part B Physician Fee Schedule. In 2009, the incentive increased to two percent (2%). Click for White Paper.
HITECH Act: Privacy & Penalties
The HITECH Act brings with it expanded privacy and security laws that could significantly affect any practice. Changes have already been set in motion to begin this year (2010) with some beginning later. The application of these new regulations are rigorous and merit a full a understanding. Click for White Paper.
EMR Training
In general, out of the box EMRs have only web based training; the quality of that training is notoriously bad as has been noted in many trade organization articles. After customization, your EMR system will be somewhat foreign to these vendors, which is why we work directly with the developers for a smooth adoption into your workflow to which our team is sensitive. Our team has a keen eye on assuring that the revenue cycle is not interrupted. Our team’s experience counts.
The quality of training from the EMR vendors is notoriously bad. Many articles in trade journals address this issue. After customization, your EMR system will be somewhat foreign to these vendors. They are not sensitive to workflow and the cash dependence of medical practices. Because HIT, LLC has customized your system, we know it. Because of our experience with change management and workflow analysis we work with you to understand your needs. Training will be specific to your practice, your product and your database.
EMR Customization
Out of the box, EMR systems are only marginally usable. They are not as immediately useful as vendors claim. All of these systems need some customization prior to full configuration, training, implementation and release to providers. HIT, LLC understands this, is experienced with customization, and with our ensemble of experts can do it quickly, effectively and efficiently. We understand the need that providers have for custom application and look forward to working with them. As we say in our project dynamics “we can’t direct the wind but we can readily adjust the sails!”
EMR Deployment
Once all stakeholders are tested and fluent we “Go-Live”. We do this in phases to coincide with the needs of patient flow as well as cash flow. Return to productivity in a reasonable and acceptable time is critical. In addition, our typical client receives a healthy return on investment. Payback is achieved; even with no government funding or additional P4P incentives.
EMR Support
Providers are busy seeing patients. They do not have time to call a help desk if their system is crashing. That is why HIT, LLC creates “Level I” support within every practice site. Each of our client’s practices has its own super-user who can answer simple questions so providers can continue their daily routines without interruption. Super-users can always “bump” a technical problem or system question to us – we are always available and easy to reach. We specialize in providing assistance specific to each of our clients’ customized EMR system. With HIT, LLC there will be no need to wait in long EMR vendor help desk queues only to get non-specific answers to your questions.
EMR Maintenance
Your system and its implementation will be orchestrated where it is updated and maintained automatically. In most cases this will occur in the background, seamlessly and without the user’s awareness. We provide necessary user acceptance testing, education and training for the upgrades and any other significant changes to the EMR. We continually manage your hosting services to ensure that your EMR and data are safe and available to you whenever you need them.
Healthcare Information Technologies, LLC is a leading Healthcare Consultancy. As the eHealth Partner to many Medical Practices, Hospitals, Clinics, IPAs and ACOs, we are responsible for the technology solutions that our partners need, from clinical integration to complete revenue cycle management, including strategy, selection, implementation, training and support.
We take very seriously our commitment to providing all of our clients with all of the eHealth tools and resources they need for greater operational efficiency and increased level of patient care. We are a long term partner, here to help you navigate the constant changes in healthcare IT by providing you the best solutions available. Success is the only option.
We take very seriously our commitment to providing all of our clients with all of the eHealth tools and resources they need for greater operational efficiency and increased level of patient care. We are a long term partner, here to help you navigate the constant changes in healthcare IT by providing you the best solutions available. Success is the only option.
Chief Executive Officer
(727) 455-7922
ggrice@emr-hit.com
Greg Grice has over 20 years of experience and success in contract negotiation and administration including global applications. His career started with Hank Dickerson & Company–a large brokerage firm in Dallas, Texas after attending Baylor University.
He successfully underwrote, and saw “through to a conclusion” many multi-faceted and complex transactions, which were on the cutting edge of technology. After working with the president of Dickerson for many years, Greg relocated to Florida, where he headed up global markets for one of the world’s largest real estate firms–Marcus & Millichap.
Greg utilized his vast experience, his insatiable thirst for innovative technology, along with his roots in healthcare to become a valued asset as Managing Director of Healthcare Information Technologies, LLC.
Chief Financial Officer
(772) 223-4683
cpope@emr-hit.com
Charles Pope comes from the financial industry, where informatics is not only critical but is the backbone of the industry. A University of Florida graduate in Finance and Florida Institute of Technology MBA, he has over 30 years of banking and finance experience as a senior officer at Atlantic National Bank, Seacoast National Bank and First American Bank, NA. In his focus on Major Financial Facilities including Venture Capital, Current Asset Lending, LBOs and Buy-Ins, Mr. Pope has worked with JP Morgan Chase, Citi, Barclays and a myriad other money center and regional banks. He was senior project manager with Harris Corporation in analytics and business modeling.
In today’s changing world of healthcare, he uses his comprehensive understanding of the medical financial arena, medical informatics and the business dynamics of medical practices. He also serves as a liaison with the South Florida Regional Extension Center and the Office of the National Coordinator, Washington, DC, and is a network partner with the Health Access Network Delivery System (HANDS) in Fort Pierce, Florida.
Chief Marketing Officer
(828) 553-3940
kwalker@emr-hit.com
Before starting her first database management company in 1999, Kristin Walker gained real-world experience as the account manager of a medical practice in California and the financial officer of a dental group in Oklahoma. She was soon recruited to work in Texas with a private dental consulting company, which offered assessment, training and motivational guidance to its clients. Her multiple encounters within the health care industry taught her that one of the keys to success in any business is managing high quality customer relationships.
Kristin now owns several successful companies, including everythingCRM and everythingEMR that develop customized CRM and eMarketing solutions. Her corporate clients have included Assurant Healthcare, Dell, Perot Systems Healthcare, and Morgan Stanley. As Chief Marketing Officer at Healthcare Information Technologies, LLC, Kristin brings the full force of CRM technology to aid our clients in expanding their marketing and organizational capabilities. Her combination of financial, healthcare and customer relationship skills make her the consummate marketing officer.
ADVISORS
Ryan earned his JD from Nova Southeastern University School of Law with honors in 2002 and his Bachelors from Florida State University. Immediately after law school, he spent a year as corporate counsel to American Pioneer before joining the firm of Grazi and Gianino. Having closed more than 100 million dollars of transactions has given him a solid background in commercial and business law. Ryan’s insight, strategic thinking and depth of perception are invaluable as general counsel to Healthcare Information Technologies, LLC.
Ajay earned his Medical Degree and BA under the Accelerated Medical Program, University of Missouri, 1992, interning at Reading Hospital with Residency in Radiology at University Health System of the University of Pennsylvania, 1997.
In addition to his stellar academic accomplishments, he has Board Certifications from National Board of Medical Examiners, Diplomate, American Board of Radiology, Diplomate, Certificate of added qualification, American Board of Radiology, Angiography, and Interventional Radiology.
Ajay has applied his knowledge and experience to building his successful radiology practice, utilizing technology to drive quality of care and efficiency. He uses the technology that is offered by Healthcare Information Technology, LLC.
Tom earned his Medical Degree from Vanderbilt University after graduating from University of North Carolina, Chapel Hill where he was a Morehead Scholar; Fellowship of Asthma & Pulmonology, University of Iowa. In addition to his vast medical knowledge and experience, Tom has a great deal of business acumen, which he has gleaned from successfully running his large practice.
Applying his MBA, he has made his practice a model of efficiency: improving patient care, reducing overhead, increasing reimbursements and expanding his practice with technology. Tom is an avid user of one of the products of Healthcare Information Technologies, LLC, so much so that he has put together a training organization to assist in HIT’s implementations and ongoing support.
Vincent earned his University of Miami MD in 1981 after receiving his bachelors, with honors, from University of South Florida, where he had a dual major of chemistry and biology. He completed his internship and residency at Alameda County Medical Center, Oakland, California.
He is Emergency Medical Director and Director of Flight Care, Department of Emergency Medicine at Enloe Medical Center, Chico, California. He also serves as Assistant Medical Director, Chico Emergency Physicians Medical Group.
Kevin earned his Duke University MD in 1979 after receiving a Bachelors in Psychology from Princeton University. He completed a family medicine residency at the University of Missouri-Columbia. He received an MBA at Drexel University in 1985 with a concentration in information systems while working as a contract physician for the Philadelphia Health Department.
In a 30-year career, he has held academic, clinical and executive positions. His successes include writing and implementing a PC-based program for an academic primary care practice to handle accounting under managed care programs in the 1980s, achieving residency accreditation for a major university program that had fallen on hard times in the early 1990s and serving from 1999 to 2004 as the first and only (to this date) department-level physician executive in State government, responsible for improving healthcare policy for children and youth programs.
These accomplishments provided him unique and broad experience with healthcare policy, information systems development, and teaching in a wide variety of organizational and patient/consumer settings and cultures while developing conceptualization, public speaking and leadership skills. He has continually practiced family medicine in many different environments, both urban and rural, most frequently in the public sector.
Arti has about twenty years of professional experience and comes from a medical, as well as Information Technology background. While practicing medicine, she worked at various hospitals in Mumbai, India apart from having her own practice in family medicine.
She has a degree in Allied Medicine (Homoeopathy) from Maharashtra Council of Homoeopathy, India. After about eight years of medical career, she took up courses in Graphics & Animation and worked as a Research Faculty and Technical Manager with Graphics and Animation Institute. During this time, she provided corporate trainings in 3D animation and authored various courseware in 2D/3D animation, desktop publishing, image editing and AutoCAD. It was during this time she became interested in software programming and obtained her professional certification in network centered Software Engineering. She is also a Sun Certified Programmer for Java 2 platform. For past ten years, she has been active in Information Technology having a concentration as a Business Analyst for software projects for the US Government. Additionally, she has worked on product migration through reverse-engineering requirements on a new technology platform for US Capital Market product’s company (BFSI). Other domains include Finance, Healthcare, Pharmaceuticals, Humanitarian organizations, Insurance and other integrated services. She has also done Six Sigma greenbelt projects.
Arti has tremendous hunger to learn new things and that has led to her vast and diverse portfolio of skills and experience.
Paul is a urologist with a long history in the medical field. He describes himself first as a patient, then as a doctor. This comes from his personal lifelong history as a renal transplant recipient twice over. He became a physician with the goal of hoping to empathize with the patient, thereby giving a more complete healthcare experience.
Personally and throughout his training, he has dealt with technology. His interest came early in the 90s with the advent of the Internet. As an early adopter, he has realized the improved patient care and timesaving that this afforded. Early in his career, he identified the goal to be involved in the integration of medicine and technology. He is part of the Information Technology Steering Committee at his organization. Additionally, he has been part of Health 2.0 and Health Information and Management Systems Society. As a member of the American Medical Informatics Association, he is continually educating himself in Biomedical Informatics and most recently the 10x10 course at Oregon Health State University.
His thrust is not only to be involved in the modeling and building of a new national medical infrastructure, but of a global one as well. An integral component of his advisory to Healthcare Information Technologies, LLC is to assist in providing straightforward and superior service to his peers in the medical community. Dr. Seville is invaluable to the firm.