Bethany Chambers

Until now you might have  guessed how the switch to the International Classification of Diseases 10th  Revision (ICD-10) will affect your practice’s bottom line, without having much  data to support your hunches. That’s about to change.

A new online calculator  allows you to see the economic hit you’ll take when the new system is enacted  in 2014-and then gives you ways to prevent a financial catastrophe.

The Healthcare Information  and Management Systems Society’s (HIMSS) 

 offers  a risk rating for revenues, cash flow, and operational costs, and then compares  your risk with that of similar practices.

The free calculator is an  addition-and perhaps entryway-to the 

successful transition to the new coding system

“The  calculator provides hospitals and physician practices with a way to quickly  assess the financial risk that ICD-10 poses to their organizations,” says 

. “By simply answering a short survey,  providers receive unique insight into the 

, steps they can take to address those  impacts, and ways to augment their accounts receivable even before they  complete their conversion to ICD-10.”

Physicians, administrators,  or other support staff can complete the survey and have results emailed within  2 to 3 days. The small practice survey, which has 25 questions, considers a  practice’s location, denial rates, Medicare dependence, daily average claim  acceptance, and other data. It looks at less tangible factors as well, such as  how much you know about vendor performance and how recently you’ve performed a  billing audit.

Because you cannot stop and  save the survey once you’ve started, HIMSS advises you to print the questions  in advance and determine your responses.

, composed of technology, finance, and  management experts from corporations, consultancies, and healthcare systems,  teamed with healthcare compliance technology company Jvion LLC to produce the  interactive tool.

Although your answers to the  questions are anonymous, Jvion will be collecting the data to provide a  big-picture view of the effects of ICD-10 and tailor its products toward those  provider groups that are most at-risk.

Resource Center: ICD-10 Information Center

Articles

Wondering what effect the new coding system could have on your practice's bottom line? A professional organization introduces a handy tool for forecasting your finances.

HIMSS: Online tool determines financial effect of ICD-10

If you have  ideas for how to best share your electronic health records (EHRs) with patients,  you’re in luck. An international organization backed by some of your  professional groups just released a guide for giving patients access to  records, and the health information technology (HIT) leaders behind it want  your opinion. There’s just one catch-you’ll need to be fluent in tech-speak to  read the 36-page draft.

The group, Integrating  the Healthcare Enterprise (IHE) posted the

 implementation guide in June. No  deadline has been set for public comment.

“Mobile  health is a rapidly emerging market, with a strong demand for health data  access,” says John Moehrke, standards and interoperability expert for GE  Healthcare, who worked on the document. “We are really looking forward to  industry feedback.”

IHE has 510  member organizations worldwide, including the Healthcare Information and  Management Systems Society and the American College of Physicians. IHE’s mission  is to improve interoperability between HIT systems.

The guide  takes earlier specifications for computer- or server-based data exchange and  offers a simplified, Web-based interface that could work on providers’ and  patients’ smartphones and tablets.

This  technical framework comes as Congress prepares to set a deadline for the  regulatory framework for mobile health access. 

Instead of  limiting access just to health information exchanges (HIEs), documents also  could be delivered via patient portals, EHR systems, and personal health  records (PHRs). Specifically, the framework could be used for:

PHR  mobile apps that link to EHRs or HIEs;

The guide lays  out processes for submitting information from a mobile device to a system,  pulling the metadata for the correct record from the system, using the metadata  to find and link documents based on the query, and retrieving a copy of the  information.

Last week the  Senate approved the final version of the 

Food and Drug Administration Safety  and Innovation Act

. If signed by President Obama, the  Department of Health and Human Services and several other groups would have 18  months to make recommendations for how to regulate HIT and assess risks.

IHE is asking  for comments on security risks, programming protocols, and access limitations,  among other topics integral to mobile health records. To comment, visit 

www.ihe.net/Technical_Framework/public_comment.cfm

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An international group wants your opinion of its guide for providing private health information to patients via smartphones and tablets. There's just one catch.

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Two government agencies  released tools recently that could help you meet the mandated e-prescribing  deadline-or at least apply for an extension if you can’t meet the deadline. But  you’ll have to act before June 30 to avoid a cut to your Medicare payments.

The Agency for Healthcare  Research and Quality (AHRQ) released a 

toolset to help physician offices begin  e-prescribing

. The  toolset, available at no charge at the AHRQ Web site, has 11 downloadable  documents, including:

surveys  to determine whether you’re ready to e-prescribe (eRx), such as assessments of  computer skills and healthcare information technology (HIT) infrastructure;

a team  roster to nominate “candidates” for specific tasks and assign duties for the  new processes;

a goals  worksheet and poster to explain why you’re pursuing e-prescribing and  techniques for measuring your success; and

handouts  to explain the change to patients and local pharmacies.

The AHRQ Web site says the  toolset is designed for everyone from small, independent offices to large  medical groups.

“The toolset  may be of particular use to small or solo practices that may not have the  resources to hire external IT experts to assist with implementation efforts,” Teresa Zayas Cabán, PhD, AHRQ senior manager for HIT,  tells 

. “More  successful implementations will allow realization of the benefits that these  systems can offer in terms of patient safety and healthcare efficiencies and  support organizations as they try to meet federal incentive program  requirements.”

 released by AHRQ also may be worth a look, Cabán says. 

“Primary care  providers could benefit from reading or reviewing [it] to understand in more  depth how prescriptions are transmitted to, received by, and processed at the  pharmacy, so they can better support medication management processes using e-prescribing,”  she says.

The help may be just in time  for practices on the cusp of meeting the June 30 deadline to avoid the 2013 eRx  payment adjustment. If not, the Centers for Medicare and Medicaid Services  (CMS) released its own tool to help you apply for a hardship exemption.

Quality Reporting Communication Support Page

 on CMS’ Web site allows anyone participating  in the group practice reporting option to ask for an exemption without having  filed a single e-prescription, although requests still can be made during the  claims process. The page also has a 

Individual physicians must  have filed at least 10 eRx claims, and small practices must have filed 625 claims,  between January 1 and June 30 to be considered successful e-prescribers. Those  who are not successful and do not receive an exemption will lose 1.5% of their  Medicare Part B physician fee schedule payment. That’s on top of the 1% lost in  2012 for not filing in the 2011 calendar year.

Exemptions are available for a  variety of reasons, including low prescribing numbers, lack of Internet access,  or too few pharmacies able to receive e-prescriptions.

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If you haven't filed your 2012 e-prescriptions--or filed for an exemption--help is here. See what tools could save you from big payment cuts.

AHRQ, CMS release tools before 2013 eRx deadline

Despite the  hundreds of electronic health record (EHR) systems available, a new study finds  no single market leader, although several vendors are positioning themselves to  be in the future.

” by market research firm  International Data Corp. (IDC), analyzed 11 commonly used systems developed by  nine vendors. The results were determined by combining independent data with  vendor and end user interviews. 

The study  looked at 25 categories, including pricing, innovation, customer service, and  approach to meaningful use requirements. Only systems that met basic measures  were analyzed. The counterpart to a 

study last year of EHRs used by  midsize-to-large practices

,  this study looked more closely at ongoing costs and delivery models for  practices with 10 or fewer providers, researchers said.

“One of the  things we saw in end users we spoke to is that pricing is less important than  the value they see from the applications,” 

None of the  systems landed in the top “leaders” quadrant, although eight fell in the second  quadrant of “major players.” eClinicalWorks topped the list and had one of the  largest market shares, receiving a “plus” in the report for its high relative  growth in users and revenues. 

“The small  practice space…is relatively immature,” Hanover says. “We do see emerging and  changing functionality, but most of the vendors are in the under-20% market  share.”

 included Greenway PrimeSuite and  Optum Physician EMR (formerly called CareTracker), with PrimeSuite reporting  the greater growth rate of the two. Allscripts Professional EHR, which had one  of the largest market shares of the systems analyzed, ranked just below.  According to the study, the system has lower relative adoption. Meditech LSS  MPM, the lowest-ranked system, was at the bottom of the third quadrant, “contenders.”

In a  conference call last week, Hanover offered several suggestions for practices  considering purchasing an EHR system:

Consider  the financial stability of the vendor.

Pay  attention to the product’s functionality and release of new features.

Assess  compatibility with mobile devices.

Leverage  existing practice management investments in looking for integrated EHRs.

Look  for vendors that specialize in small practices for simple, easy-to-use  applications and vendors that offer software-as-a-service options that lower  infrastructure requirements.

Perhaps most importantly,  Hanover says that practices should look past meaningful use when thinking about  the needs and goals of an EHR. If not, she warns, practices “will only see the  short-term incentives and not the long-term benefits.” 

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Author | Bethany Chambers

Articles

HIMSS: Online tool determines financial effect of ICD-10

How best to provide mobile access to health documents

AHRQ, CMS release tools before 2013 eRx deadline

Study finds no leaders in electronic health record systems for small practices