Archive for the ‘Healthcare IT’ Category

CMS Paid out the First Payments for the EHR Incentive Program. Are you registered?

July 18, 2011

Since the EHR incentive program opened in January of 2011, more than $158 million has been paid for both the Medicare and Medicaid EHR incentive programs.  In total, the Federal government has paid:

  • $75 million for the Medicare EHR incentive program
  • $83.3 million for the Medicaid EHR incentive program

The following are notable differences between the Medicare and Medicaid EHR incentive programs:

Medicare

Medicaid

Federal Government will implement (will be an option nationally) Voluntary for States to implement (may not be an option in every State)
Payment reductions begin in 2015 for providers that do not demonstrate Meaningful Use No Medicaid payment reductions
Must demonstrate Meaningful Use Year 1 Adopt, implement and upgrade option for 1st participation year
Maximum incentive is $44,000 for Eligible Professionals (10% bonus for Eligible Professional in Health Professional Shortage Area) Maximum incentive is $63,750 for Eligible Professionals
Meaningful Use definition is standard for Medicare States can adopt certain additional requirements for Meaningful Use
Last year a provider may initiate program is 2014; Last year to register is 2016; Payment adjustments begin in 2015 Last year a provider may initiate program is 2016; Last year to register is 2016
Eligible Professionals include:

  • Doctor of medicine or osteopathy
  • Doctor of dental surgery or dental medicine
  • Doctor of podiatry
  • Doctor of optometry
  • Chiropractor

…and subsection (d) hospitals and Critical Access Hospitals (CAHs).

Eligible Professionals include:

  • Physicians (primarily doctors of medicine and doctors of osteopathy)
  • Nurse practitioner
  • Certified nurse-midwife
  • Dentist
  • Physician assistant who furnishes services in a Federally Qualified Health Center or Rural Health Clinic that is led by a physician assistant.

…and acute care hospitals (including CAHs) and children’s hospitals.

In order to receive the Medicare or MediCaid EHR incentive payments, follow the steps below:

  1. Successfully register for the Medicare EHR Incentive Program;
  1. Meet meaningful use criteria using certified EHR technology (Check to see if your software is certified  under the EHR incentive program at: http://onc-chpl.force.com/ehrcert); and
  2. Successfully attest, using CMS’ Web-based system, that you have met meaningful use criteria using certified EHR technology.

20 Free iPhone Medical Apps

June 28, 2011

The following is a listing of the 20 free iPhone medical applications (apps) for health care professionals which was compiled by iMedicalApps.  Not only these apps could be useful but they could also be used to obtain CMEs.Medical Applications for iPhone

1. Medscape

Medscape is an app with 7,000+ drug references, 3,500+ disease clinical references, 2,500+ clinical images and procedure videos, robust drug interaction tool checker, CME activities, and more.

2. Micromedex

This is a prescription medical reference app.

3. New England Journal of Medicine

The NEJM app allows access to the last 7 days worth of published articles, along with images of various medical conditions and videos on how to perform procedures such as LPs and chest tubes. NEJM has weekly audio summaries and the selection of four full text audio reads of clinical practice articles which can be accessed via a podcast format as well.

4. Epocrates

Epocrates is one of the best medical reference tools in the mobile format.  The free version of Epocrates, Epocrates Rx, provides great content: Drug monographs and health plan formularies, drug interaction tool, pill identifier, medical Calculator, and a new addition: Medical News and handpicked clinical articles.

5. Calculate (Medical Calculator) by QxMD

Medical calculator app.

6. Radiology 2.0: One night in the ED

This is a case learning radiology tool based on content organized by Dr. Daniel Cornfeld, an Assistant Professor of Diagnostic Radiology at Yale University School of Medicine who specializes in Body and Emergency Medicine Imaging.

7. Skyscape: RxDrugs and OCM (Outlines in Clinical Medicine)

The free offerings from Skyscape are in the form of RxDrugs and OCM. RxDrugs is basically a drug reference tool, while OCM(outlines of Clinical Medicine) contains information on disease pathology.

8. Living Medical Textbooks

There are actually 5 Living Medical Textbooks, ranging in topics from Diabetes to Multiple Sclerosis.  The chapters are updated when noteworthy new medical data or research is introduced in medicine.

9. Medical Radio

ReachMD has an XM Satellite Radio broadcast (XM 160) stationthat allows medical professionals to do CME activities and keep up to date on new literature.

10. Neuromind

Neuromind is a production of Pieter Kubben, a Dutch neurosurgeon who is a clinician, researcher, and software engineer. His application is a simple reference tool for neurologists, neurosurgeons, and other clinicians who need reference material for neuro based pathologies.

11. Prognosis: Your Diagnosis

Prognosis is an app from Medical Joyworks — produced out of Sri Lanka, where one of the goals of the developers of the app was to “make medicine fun”.  The level of clinical content is more suited for medical students and paramedics, and is not advanced enough for residents and those in higher training.

12. Harvard’s Public Health News App

The Harvard School of Public Health News app features news articles from the School of Public Health.

13. Radiopaedia – Radiology Teaching Files – Lite

The application is based on the website, Radiopaedia.org— a free radiology resource written by the radiology community.

14. Ahrq ePSS

This is a public health tool provided to health care professionals by the US Department of Health and Human Services (HHS) — from the Agency for Healthcare Research and Quality (AHRQ) — the nation’s lead federal agency for research on health care quality, costs, outcomes, and patient safety. The application allows to input a patient’s age, along with other key demographic information, and gives back the basic screening and public health information pertinent for the patient. Much of the content is based on the recommendations made by the United States Preventative Services Task Force (USPSTF). The app also provides great links to screening calculators and reference tools available on the web.

15. Dragon Medical Search

Dragon Medical Search allows a user to say the phrase of a drug or clinical disease, and the user is given a roulette of resources, including ICD9 codes, to read.  The aggregated data is from Medscape, Medline, and others sources.

16. Epocrates – Calculators

Epocrates offers the following calculators for free: GFR calculator, BMI tool, STAT cholesterol, CardioMath Tool and Seattle Heart Failure Risk Calc.  A useful app for specialists.

17. MedPage Today

MedPage Today is a resource for medical professionals, and a lot of the content is in partnership with the University of Pennsylvania School of Medicine.

18. Doximity

Doximity — The “Facebook for doctors”. Doximity is a private network exclusively for physicians and medical students. Technically, the app allows the user to connect with old classmates to reminisce old times via its secured text message server, but its aim is more serious in nature.

19. Drop Box

Drop Box is technicallynot a medical app — but it can be used to help in the medical workflow. It is basically an online storage that could be accessed from anywhere.

20. 3D Brain and Lose it

3D brainis an app derived from the Genes to Cognition Online website, funded by the Dana Foundation and Hewlett Foundation.

Lose It is a great application to use when counseling patients on their diet and exercise. 

Source: iMedicalApps

New Exemptions for e-Prescribing

June 1, 2011

The Center for Medicare & Medicaid Services (CMS) issued a proposed rule that makes significant changes to the e-prescribing penalty program by adding more exemptions categories so that physicians are not unfairly penalized.

The previous rules required physicians in individual practices to submit at least 10 Medicare Part B claims with the electronic measure code eRx G8553 and an eligible encounter code by June 30, 2011, or face a claims payment reduction of 1 percent in 2012.

Physicians are still required to e-prescribe using a qualifying system and electronic measure code; but, through an online web portal, will have an opportunity to show eligibility for one of the following exemptions:

  • Physician’s practice is located in a rural area without high speed internet access;
  • Physician’s practice is located in an area without sufficient available pharmacies for electronic prescribing;
  • Physician is registered to participate in the Medicare or Medicaid electronic health record incentive (EHR) program and has adopted certified EHR technology;
  • Physician is unable to electronically prescribe due to local, state or federal law or regulation (e.g., prescribes controlled substances);
  • Physician infrequently prescribes (e.g., prescribe fewer than 10 prescriptions between January 1, 2011, and June 30, 2011); and
  • There are insufficient opportunities to report the e-prescribing measure due to program limitations

Physicians will have to apply for an exemption from the 2012 e-prescribing penalty via the online web-portal by October 1, 2011.

The proposed rule can be viewed at the Office of the Federal Register website. It will be published in the Federal Register on June 1, 2011. The comment period closes July 25, 2011.

EHR Incentive Program Checklists

May 23, 2011

The Medicare and Medicaid EHR Incentive Programs checklists will show you the steps to take to receive your incentive payments, but first: EHR Incentive

  1. Find out if you are eligible for either the Medicare or Medicaid EHR Incentive Programs.
    • Professionals and hospitals can visit the Eligibility page to check eligibility.
  2. Are you a professional eligible for both programs? If so, you must choose a program and follow the rest of the relevant checklist below.

Not sure which program to choose? Compare “Notable Differences between the Medicare and Medicaid EHR Incentive Programs” .

Medicare EHR Incentive Program Checklist

If you’re an eligible professional, become a meaningful user of certified electronic health records to qualify for incentive payments of up to $44,000 from Medicare. Here’s how to qualify:

  • Make sure you’re eligible for the Medicare EHR Incentive Program. View eligibility guidelines at our Eligibility page.
  • Also eligible for the Medicaid EHR Incentive Program? You can receive higher incentive payments, up to $63,750, through the Medicaid EHR Incentive Program. See the Medicaid checklist.
  • Get registered. Registration is now open to eligible professionals. Visit the Registration page for more details.

Note: Register as soon as possible. You can register before having a system installed.

  • Use certified EHR technology. To receive incentive payments, make sure the EHR technology you’re using or are considering buying has been certified by the Office of the National Coordinator for Health Information Technology. Visit our Certified EHR Technology page for details.
  • Be a Meaningful User. You have to successfully demonstrate “meaningful use” for a consecutive 90-day period in your first year of participation (and for a full year in each subsequent years) to receive EHR incentive payments. Visit our Meaningful Use page to learn about meaningful use objectives and measures.
  • Attest for incentive payments. To get your EHR incentive payment, you must attest (legally state) through Medicare’s secure Web site that you’ve demonstrated “meaningful use” with certified EHR technology. You can now get to our secure Attestation Web site through a link at our Attestation page.

Medicaid EHR Incentive Program Checklist

If you’re an eligible professional, in your first year of participation you may adopt, implement or upgrade or become a meaningful user of certified electronic health records to qualify for incentive payments of up to $63,750 from Medicaid. Here’s how to qualify:

  • Make sure you’re eligible for the Medicaid EHR Incentive Program. View eligibility guidelines at our Eligibility page.
  • Also eligible for the Medicare EHR Incentive Program? Eligible professionals can receive up to $44,000 through the Medicare EHR Incentive Program. See the Medicare checklist.
  • Get registered. Visit the “Medicaid State Information” page to see if your state is participating in the Medicaid EHR Incentive Program.
  • If your state is already participating, register now for the Medicaid EHR Incentive Program.  Visit the Registration page for more details
  • If your state has not yet begun participating in the Medicaid EHR Incentive Program: you may wish to register now for the Medicare EHR Incentive Program, if you’re eligible for both programs. See the Medicare checklist.

Note: Register as soon as possible. You can register before having a system installed.

  • Use certified EHR technology. To receive incentive payments, make sure the EHR technology you’re using or are considering buying has been certified by the Office of the National Coordinator for Health Information Technology. Visit our Certified EHR Technology page for details.
  • Get qualified. To receive EHR incentive payments in the first year under the Medicaid EHR Incentive Program, you must do at least one of the following:
    • Adopt certified EHR technology; or
    • Implement certified EHR technology you have already purchased; or
    • Upgrade your current EHR technology to the newly certified version; or
    • Demonstrate “meaningful use” of certified EHR technology for a 90-day period. Visit your state’s Medicaid agency Web site or our Meaningful Use page to learn about meaningful use objectives and measures.
  • Attest for incentive payments. To get your EHR incentive payment, you must attest (legally state) through your state’s Medicaid agency Web site that you’ve met all of the eligibility criteria, including having adopted, implemented, upgraded or meaningfully used certified EHR technology. Visit your state’s Medicaid agency Web site for more information.

Source: CMS

2011 Medicare e-Prescribing Incentives and 2012-2013 Medicare e-Prescribing Penalties

May 16, 2011

The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) authorized a new and separate federal incentive program for eligible professionals (EPs) who are successful electronic prescribers.  This incentive is in addition to the electronic health record (EHR) program and the Physician Quality Reporting System (PQRS) program.

Providers could qualify for multiple incentive programs.  However, within the same year, providers could only qualify for the Medicare EHR incentive program OR the Medicare e-Prescribing incentive  program, not both.  Therefore, it would be advisable to participate for the e-Prescribing incentive program for 2011 and then apply for the Medicare EHR incentive program in the following year.  If the provider chooses to participate in the MediCaid EHR incentive program and the Medicare e-Prescribing incentive program in the same year, the qualified provider is eligible to receive incentives under BOTH programs.

Benefits of e-Prescribing

First, e-Prescribing is offered as a way to prevent medication errors that arise due to difficulties in reading or understanding handwritten prescriptions.  In addition, e-Prescribing could reduce adverse drug events (ADEs) by making information such as drug interactions and contraindications available to prescribers at the time they are preparing a prescription.  Finally, e-Prescribing may reduce patients’ out-of-pocket costs by placing formulary, coverage and copayment information at prescribers’ fingertips.

Reporting Period

The reporting period for the 2011 e-Prescribing incentive program will be for the entire 2011 calendar year (January 1, 2011 through December 31, 2011)

Incentive Amount

The 2011 Medicare e-Prescribing incentive program provides an incentive payment to eligible physicians who successfully e-Prescribe medications in 2011 equal to 1% of their total Medicare payments for the year.  For example, if you bill Medicare $100,000 in allowable charges in 2011 and successfully report on e-Prescribing, you would receive $1,000.

Year     Incentive Amount

  • 2011     1.0%
  • 2012     1.0%
  • 2013     0.5%
  • 2014     0.0%

Note: Payment bonuses are made after the conclusion of the calendar year in which eligible physicians e-Prescribe for their Medicare patients, not as an up front payment.

Reporting Requirements

To participate in the 2011 e-Prescribing incentive program, individual eligible physicians may choose to report on their adoption and use of a qualified e-Prescribing measure, G code, G8553.

Sample Claim Form With G-Code

In order to receive incentive payments for e-Prescribing in 2011, eligible physicians must report the e-Prescribing G-code, G8553, at least 25 times on their claim forms. At least 10 of the 25 claims should be reported between January 1, 2011 through June 30, 2011 reporting period.

Penalties

According to MIPPA, physicians who are eligible but choose not to participate in the 2012 or 2013 Medicare e-Prescribing incentive program, the following penalties would apply based on their allowable charges for the year:

Year     Penalty Amount

  • 2011     -0.0%
  • 2012     -1.0%
  • 2013     -1.5%
  • 2014     -2.0%

CMS is basing the 2012 penalties on e-Prescribing activity that occurs during January 1, 2011 through June 30, 2011, and the 2013 penalties on e-prescribing activity that occurs throughout 2011.  To avoid penalties in 2013, an eligible physician must e-Prescribe and report the e-Prescribing G-Code, G8553, at least 10 times for applicable office visits and services for the January 1, 2011 through June 30, 2011 reporting period on Medicare claim forms (report at least 25 times throughout 2011 to avoid penalties in 2013).

Exceptions to Penalty for non-Participation

The 2012 and 2013 e-Prescribing penalty will not apply to:

  • An eligible physician who has less than 100 claims for dates of service between January 1, 2011 through June 30, 2011.

OR

  • An eligible who is not a physician, nurse practitioner or physician assistant as of June 30, 2011;
  • An eligible physician for whom office visits and other services listed in the CMS e-Prescribing measure specifications represent less than 10% of their allowed charges in the first six months of 2011.

Reference: http://www.cms.gov/eRXincentive

ICD-10 / Version 5010 Timeline

April 27, 2011

ICD10_Timeline

Click the link for a copy of the timeline in .PDF: ICD-10 – TimeLine

ICD-10-CM: Benefits and Enhancement to ICD-9-CM

April 27, 2011

ICD10_BenefitsOn or after October 1, 2013, the current diagnosis code sets (ICD-9-CM) will be replaced with the new code – ICD-10-CM.  This article discusses the benefits of ICD-10-CM, similarities and differences between the two coding systems, and new features and and additional changes that can be found in ICD-10-CM.

Benefits of ICD-10-CM:

ICD-9-CM is 30 years old, has outdated and obsolete terminology that produce inaccurate and limited data, and is inconsistent with the current medical practice. ICD-10-CM incorporates much greater clinical detail and specificity than ICD-9-CM.  ICD-10-CM:

  • Incorporates much greater specificity and clinical information, which results in:
    • Improved ability to measure health care services;
    • Increased sensitivity when refining grouping and reimbursement methodologies;
    • Enhances ability to conduct public health surveillance; and
    • Decreased need to include supporting documentation with claims;
  • Includes updated medical terminology that is consistent with the current medical practice;
  • Provides codes to allow comparison of mortality and morbidity data; and
  • Provides better data for:
    • Measuring care furnished to patients;
    • Designing payment systems;
    • Processing claims;
    • Making clinical decisions;
    • Tracking public health;
    • Identifying fraud and abuse; and
    • Conducting research.

New Features Found in ICD-10-CM:

  • Laterality (left, right, bilateral)
  • Combination codes for certain conditions and common associated symptoms and manifestations
  • Combination codes for poisonings and their associated external cause
  • Obstetric codes identify trimester instead of episode of care
  • Character “x” is used as a 5th character placeholder in certain 6 character codes to allow for future expansion and to fill in other empty characters when a code that is less than 6 characters in length requires a 7th character
  • Two types of Excludes notes
    • Excludes 1 – indicates that the code excluded should never be used with the code where the note is located
    • Excludes 2 – indicates that the patient may have combination of conditions and both codes could be used
  • Inclusion of clinical concepts that do not exists in ICD-9-CM e.g. underdosing, blood type, blood alcohol level
  • Expansion of codes e.g. injuries, diabetes, substance abuse, postoperative complications
  • Codes for postoperative complications have been expanded and a distinctions made between intraoperative complications and postprocedural disorders

Additional Changes Found in ICD-10-CM:

  • Injuries are grouped by anatomical site rather than by type of injury;
  • Codes and categories have reorganize;
  • New code definitions; and
  • The current “V” codes (Factors influencing health status and contact with health services) and “E” codes (External causes of injury and poisoning) are incorporated into the main classification rather than separated into supplemental sections.

ICD-10 is Coming! Are you ready?

April 22, 2011

ICD-10The compliance date for implementation of the International Classification of Diseases, 10th Edition, Clinical Modification/Procedure Coding system (ICD-10-CM/PCS) is October 1, 2013.  There are two parts to the ICD-10-CM/PCS:

  • ICD-10-CM (Diagnosis Codes) – The diagnosis classification system developed by the by the Centers for Disease Control (CDC) and Prevention for us in all the U.S. health care treatment settings.
    • 3-7 digits
    • Digit 1 is alpha
    • Digit 2 is numeric
    • Digits 3-7 are alpha or numeric (alpha digits are not case sensitive)
        • Examples:
          • A78 – Q fever
          • A69.21 – Meningitis due to Lyme disease
          • S52.131a – Displace fracture of neck of right radius, initial encounter for closed fracture
  • ICD-10-PCS (Procedural Codes) – The procedure classification system developed by CDC for Medicare & Medicaid Services (CMS) for use in the U.S. for inpatient hospital settings ONLY.
    • 7 digits
    • Each digit is either alpha or numeric (alpha digits are not case sensitive and letters 0 and I are not used to avoid confusion with numbers 0 and 1)
        • Examples:
          • 0FB03ZX – Excision of liver, percutaneous approach, diagnostic
          • 0DQ10ZZ – Repair upper esophagus, open approach

Note: Physicians, outpatient facilities , and hospital outpatient departments should continue to use CPT codes for Medicare fee-for-service claims.

ICD-10-CM/PCS provides significant improvements through greater information and the ability to expand in order to capture additional advancements in clinical medicine.  A number of other countries have already moved to ICD-90, including:

  • United Kingdom (1995);
  • France (1997);
  • Australia (1998);
  • Germany (2000); and
  • Canada (2001).

Click the link to see the ICD10 compliance timeline: ICD10 Compliance Timeline

Medicare and Medi-Cal EHR Incentive

March 21, 2011

If you are an Eligible Professional (EP) and have already purchased a certified EHR system, then your next step is to go through registration.

First, you would need to register at Medicare for your federal incentive. If you are planning to apply for the Medi-Cal incentive, you would still need to first register with Medicare and then, sometime in April 2011, register with the state.

Watch the following video for more information about registering with Medicare:

Meaningful Yoose

March 14, 2011

Here’s what eligible providers need to know about getting incentive dollars from CMS for the meaningful use of electronic health records in under 3 minutes. The American College of Medical Informatimusicology presents the Meaningful Yoose Rap, written and performed by Dr. Ross D. Martin, directed by Ishu Krishna. Shared under the Creative Commons Share-Alike, Attribution license.


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