Official Softs

When I do a return on investment scenario for even a 1 doctor practice of an EMR, the stimulus funds are the smallest part of the return. The

productivity savings provide a larger and ongoing return.Microsoft Office is so great!

Now that being said, I wouldn’t advise running out and purchasing just any EMR without due diligence. But a properly planned and implemented

EMR system should provide a significant financial gain for the practice.Outlook 2010 is powerful.

This was a nice post by someone who has been using an EMR for long enough to know the benefits of it, as well as when it doesn’t come in so

handy.

While I agree with you that physicians should not be rushed into using anything by the government before they decide it is meaningful, it is

also important to note that there sometimes needs to be a financial incentive involved to push The invention of Microsoft Office 2010 is a big change of the world.

adoption. What I mean by that is that judging

from your example and that of many “early adopters” of EMRs, we see that there is a definite advantage of having an EMR in place. As you

said, it can improve efficiency of the office, as well as improve quality of care, and in turn increase revenues.Office 2010 –save your time and save your money.

Having said that, many physicians may still resist buying an EMR due to financial barriers and other limitations. Basically, the EMR products

may be a bit out of their price range. Thus, the government reimbursement package comes in.

So, like yourself, I see the adoption of EMRs as a good thing, but the whole idea of rushing people into buying something because of certain

criteria is a bit preposterous.Office 2010 key is for you now!

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The truth is, if our practice does not qualify then the system is a sham.

“Meaningful Use is just a ploy for the government to cut reimbursement”

The above statement is true and says it all. In recent years, many have embellished the rhetoric around meaningful use and health IT with a

lot of meaningless nonsense.

This is all about control. Third parties (all, not just the government) simply want control over Microsoft outlook is great!

physicians’ affairs. They despise physician

autonomy.

There are many more meaningful ways of improving health outcomes and reducing healthcare costs than shoving clunky EMRs down physicians’ The invention of Microsoft Office 2010 is a big change of the world.

throats. But wait, this is not really about improving health outcomes or long-term reduction in healthcare spending. It’s about control and Outlook 2010 is powerful.

further marginalizing physicians, a misguided agenda that will surely jeopardize patient care– at least, the high quality personalized

version. Microsoft Office is so great!

The health insurance industry has won the healthcare reform debate. Patients and physicians have been sucker punched.

By mandating the meaningful use criteria, the government has essentially killed the kind of innovative thinking in technology that can truly

be disruptive and address the real deficits of our healthcare system. Microsoft outlook 2010 is convenient!

Enjoyed your article. In it you stated:

“The good news for us is that doing so has made us efficient enough to increase our revenue significantly at the same time that we improve

our care quality.” Windows 7 is convenient and helpful!

I can’t speak to “care”, but as a business man in the Health IT field, I’m amazed that more of your colleagues don’t see the connection

between EMR and revenue, both top and bottom line. Office 2010 –save your time and save your money.

When I choose care providers, I’d like to know 1) Have they had an consistent and sustained increase in the percentage of favorable outcomes

for common diseases under treatment? 2) Has the use of their emergency facilities for non-emergency cases decreased? 3) Has the total cost

per health episode, adjusted for CPI, stayed the same or been lower? 4) Have there been a consistent and sustained decrease in the number of

patients you have not treated due to lack of services or resources?Microsoft Office is so great!

Generally, I’d like answers to these questions: 1) I have a set of chronic diseases — the common “metabolic syndrome” — and am working to

improve my overall health. What sort of coaching is available? How can I track my progress? Are Microsoft outlook is great!

there more effective alternatives and, if so,

what are their costs and availability from my area providers? 2) I am worried about my wife’s Office 2010 –save your time and save your money.

health. She has some chronic complaints and

uses a variety of alternative treatments for the symptoms without medical advice. What can I do to help her understand the underlying causes

and seek effective treatments to resolve them? 3) We will both be Medicare eligible soon. What is Outlook 2010 is powerful.

the optimal coverage for our healthcare,

including prescription medications?

I would not be so sure that you’re going to get that government cash. I also have been using an EMR system for years and I also use a high The invention of Microsoft Office 2010 is a big change of the world.

end product (and I pay a lot of money for it.) I am told by my EMR company that the software I use is not compliant with government

requirements and that I will have to get a new system. They have no intention of bringing their Microsoft outlook 2010 is convenient!

existing product into compliance. They also

are not sure when the upgrades will be made so it is possible that I will miss the deadlines for “meaningful use.” There are thousands of

physicians in this same situation.

LS: we are on GE, and they have been pretty forthcoming about the requirements and the few areas we need to change. I am sure there will be

companies profiteering on this, but fortunately ours is not one of them. I say that as a physician “insider” with GE, given I was president

of their user group and one of their “model” practices. Windows 7 is convenient and helpful!

Sounds like what you want is “practical use,” as advocated by a commenter over on the EMR and HIPAA blog. It’s interesting that you use the

New Child Left Behind law as a metaphor. I heard one teacher quip that the only way to achieve that goal was to slow everyone down to the

slowest child’s pace of learning. It’s like when you hear about proposals that all schools be above Microsoft Office is so great!

50th percentile in a subject: that’s

impossible, since by the rules of mathematics someone has to be in the bottom 50% (even if they’re all making As).

Unintended consequences is often true no matter the law or the issue. That doesn’t mean there shouldn’t be any criteria or judgment; as you

pointed out, rewarding those who are attempting better care is surely a noble goal, and we all want to feel our tax dollars are being well Office 2010 –save your time and save your money.

spent. I’ve tried to keep up with the ONC committee and workgroup meetings, and I think most of the members are trying to take these concerns Windows 7 is convenient and helpful!

to heart as they craft the meaningful use guidelines. The problem? They’re trying to work with deadline set by HITECH that at this point

looks almost impossible to meet. Everyone feels rushed to get HIT/EHR adoption done as fast as possible, which isn’t the ideal way to go The invention of Microsoft Office 2010 is a big change of the world.

about making such widespread, extensive changes. I think everyone would be happier if there could be a bit more time to get this thing

accomplished.

Meaningful use needs to be actually meaningful to patients.

I’m looking for specific measures. For example: 1) Has my own objective health status improved, e.g., better lab test results and weight

loss, based on data I get and use? 2) Can I can go online with my own health record and get Outlook 2010 is powerful.

specific targeted suggestions on how I might do

better, including alternatives and costs? 3) Has the total cost of my healthcare stayed the same year-to-year? 4) Can I schedule coordinated

doctor visits, lab tests, medical imaging, and specialist visits and not have to hand-carry the results?Microsoft outlook is great!

I use an EMR every day.  I use it because it helps me give better care and makes our office run more efficiently.  If we have a new process

that works better by using paper, we use paper.  We are not wed to the idea of using computers, Microsoft outlook 2010 is convenient!

we are committed to good process and

excellent care.  The good news for us is that doing so has made us efficient enough to increase our revenue significantly at the same time Microsoft Office is so great!

that we improve our care quality.  That’s what everyone wants.

It really worries me that the imposition of these criteria on EMR will dilute my focus on patients with a focus on achieving meaningful use. 

This is similar to the experience of many good teachers who had to abandon more creative teaching methods to ensure better test performance.  Windows 7 is convenient and helpful!

If the criteria are not right, they will do this; there is no question.

So before imposing a set of criteria to be evaluated on doctors, we need to be sure that the criteria themselves are scrutinized.  For them

to truly improve care and not add more burdens to medical offices, they should:Office 2010 –save your time and save your money.

•Improve doctor/patient communication

•Make information more accessible to doctors and patients

•Capture data automatically, not necessitating extra steps that could distract from careThe invention of Microsoft Office 2010 is a big change of the world.

•Capture data so it can be used for reminders and clinical decision-making at the point of care

•Improve doctor/doctor communication (primary care to specialists and hospitals)

•Capture interventions, not just outcomes.  For example, the prescription of a blood pressure medication should be rewarded, not only if the

patient takes it.  The ordering of a mammogram should be rewarded, not just if the patient gets it done.Microsoft outlook is great!

•Systems should be required to “close the loop” for interventions, meaning that ordering providers should be alerted to any test,

procedure, or consult results that do not come back.  This is an enormous problem that frustrates By using Office 2010 Professional, you can save your money and time.

many doctors and patients, increases

medical liability, and causes harm.  Computers are good at this kind of thing.

I am sure there are more, but my word count is getting high.  The bottom line:  meaningful use has to be truly meaningful.Outlook 2010 is powerful.

The intent of the NCLB law was to improve the quality of education in the US.  It established standardized testing to:

1.Set a minimum requirement for education – students cannot be passed-on to higher grades unless they pass the test.

2.Held schools accountable for quality.  Schools performing in the lowest range on the standardized testing would be publicly identified and

penalized.Microsoft Office is so great!

3.Teachers with low student scores would be penalized as well.Outlook 2010 is powerful.

But the law of unintended consequences has caught up with NCLB, with schools/teachers “gaming” the system, undo focus on test-passage over

comprehensive education, and squashing of teacher creativity with fear of low test-scores.  Talking to teachers and parents (as a Office 2010 download is available now!

pediatrician), there is very little love for the NCLB law.

And children pay the price of this legislation as well.  I saw a child recently who is a very hard worker, a very conscientious child, and

who has been able to get mainly B’s in his classes.  The problem for him is that he does not take Office 2010 –save your time and save your money.

standardized tests well.  Despite

medication and even allowances made in the testing setting, he fails the test which covers information he has shown in the classroom that he

knows.  The government calls his school and teacher as the cause of his failure, but he is the one who has to be held back until he’s able

to pass the test.By using Office 2010 Professional, you can save your money and time.

In the same way, making a bunch of criteria for EMR use is sure to have a slew of unintended consequences.  Doctors will select EMR systems

based on meaningful use criteria, not on how well they work.  Doctors will select patients who can get the scores higher and discharge those

who probably need the most help.

Sounds familiar.

Meaningful Meaningful UseThe invention of Microsoft Office 2010 is a big change of the world.

What should be done?  The real question should be: what can an EMR do to impact patient care that would be truly meaningful?  If an EMR

improves the ability of the doctor to take care of the patient, that is meaningful.  But if the EMR makes the doctor pay more attention to

qualifying for the cash payment than to the real care of the patient, it is more meaningless use.Office 2010 key is for you now!

What does the term “meaningful use” mean?

a.  Using something in a way that gives life purpose and leads to carefree days of glee.

b.  It depends on your definition of the word “term.”

c.  It is not mean.  It is really nice.Microsoft outlook is great!

d.  A large number of rules created by the government to assess a practice’s use of electronic medical records so that they can spur

adoption, give criteria for incentive rewards, and have physicians in a place where care can be measured.

e.  Job security for those making money off of health IT.

The answer, of course is d and e.

Meaningful Use, in the eyes of many is seen as curse words, especially doctors. Outlook 2010 is powerful.

Under the plan, physicians will be paid cash dollars for meeting these criteria.  Here’s the payment:

2018 and beyond  – 2% penalty.  More criteria to qualify?  More quality measures?  More penalties for not meeting criteria?  Stricter

criteria for A1cs?  Other insurance companies using the same criteria or different criteria?  More Microsoft outlook 2010 is convenient!

government control is a definite.

So what’s the big deal?  Why would doctors be against getting extra money?  Here are some of the main reasons:

1.They don’t want to use EMR and feel like the government is forcing them

2.They think the rules are so onerous that it’s hopeless to even try

3.They only like yellow charts, and the blue ones make them feel depressedWindows 7 is convenient and helpful!

4.They see that eventually non-adoption of EMR will be penalized.  This makes many conclude that Meaningful Use is just a ploy for the

government to cut reimbursement.

I too wish the chart was yellow, but overall I am not upset about all of this.  The reason I am not upset is entirely selfish: I have been on

EMR for 14 years and use a high-end product, so I will very likely be awarded the full $$ and avoid penalties.  I also see this as an

opportunity for physicians practicing good care to be seen as good doctors, and the bad ones to actually be penalized instead of rewarded. Microsoft Office is so great!

You see, I have always seen EMR as much more than a computerized version of the paper chart.  The true value in EMR is not that you get to

type, it is that all of the information is stored in a single place, organized, and easily retrieved when needed.  Using an EMR for

documentation alone is like using a car to travel only as fast as you can walk.  If payment is not so much based on the quality of my coding The invention of Microsoft Office 2010 is a big change of the world.

and my note-taking, but instead based on the quality of the care I give, isn’t that a good thing?  Isn’t that what we should want?

No Patient Left Behind

The devil is in the details.  Or, to be more accurate, the devil is in DC.  The real problem with meaningful use is the fact that it is a Office 2010 –save your time and save your money.

mandate.  Mandates like this – the use of testing/criteria by the government to get people to act in a certain way – have a huge flaw. 

This is best understood with another mandate of the government that has caused it’s own trouble: the No Child Left Behind law of 2001.

My plan now, which usually proves wrong and changes 100 times, is to design the plan with an additional deductible, if the member checks the

website and chooses one of the cost edffectibe providers that deductible will be waived. I think it will only work with financial Office 2010 –save your time and save your money.

rewards/penalities.

I really love the concept though, I think it has a better chance then most recent ideas to lower cost without negative impacts, or potential

negative impacts blown way out of proportion by people with no understanding of healthcare insurance and deliveryMicrosoft Office is so great!

Looks like we’re basically going in the same direction. One reason to use historical claims over fee schedules is that you also collect data

on practice patterns. A sophisticated algorithm will bundle claims usually seen together for treatment of a condition (actually seen

together, not just hypothesized according to best practice theory). Likewise, if provider A tends to The invention of Microsoft Office 2010 is a big change of the world.

upcode while provider B does not, you

could capture that in the algorithm to generate the cost estimate. I like this feature a lot.

The downside of using claims data is that to generate accurate estimates you need to look back quite a while…typically more than a year to

get a sufficient number of data points, especially if you are doing a provider-by-provider estimateMicrosoft outlook 2010 is convenient!

. If some of the data is two years old, it

probably isn’t the same fee schedule as something being paid today. More sophistication in the algorithm is needed to account for that, or

just let the data be what it is and provide caveats to users.

“The downside of using claims data is that to generate accurate estimates you need to look back Windows 7 is convenient and helpful!

quite a while”

Exactly, lacking large enough data set is a huge problem and one reason we needed to partner with the PPOs, we have business in most states

but not significant data in any one. If we only relied on our data it would be meaningless. The problem we are left with is not all PPOs Microsoft outlook is great!

support this concept, many are just shakedown partners for providers. If they won’t let us audit a certian hospital’s bills I am certain they Outlook 2010 is powerful.

aren’t going to let us push data telling people not to go there in the first place.

As Nate and Vikram note, there is no reason to think that a payer just putting this up on the website and issuing a press release will result

in a significant number of people using it. The lesson of Kaiser is that you need a critical mass of Office 2010 –save your time and save your money.

things on the website before it is a go

-to destination: appt. scheduling, e-visits, claims/encounters, Rx, Labs, PHR, decision support (preventive health reminders), Health Risk

Assessment, etc. Here the whole is more than the sum of the parts.

Nate, are you using individual provider fee schedules, or something else? Big article in the NY Times on Castlight Health and price Microsoft Office is so great!

transparency. They apparently are using EOBs (not sure how they collect them), though presumably you wouldn’t have to resort to that.

We’re also going in this direction. My take based on early data: for now, people will use this than they do PHRs, but not by that much, and

it depends on the amount of cost-sharing in the product. Also, in keeping with my previous post: if your website doesn’t have much of

interest on it other than claims review and doc search, you won’t have the critical mass of traffic needed to make a tool like this highly The invention of Microsoft Office 2010 is a big change of the world.

successful.

“If a doc has unused capacity in Duluth that would go to waste, instead someone hours away in Grand Portage could go for a visit without

leaving home.”

This is a very interesting point and the effect it could have on rural healthcare. A doctor could set up shop in small town america, have

affordable housing and excellant quality of life and still treat the patient base in the big dirty cities. Not all visits can be remote but a

good number of doctors have a better life to look forward to.

We use maybe 30 different PPOs so it ranges all over the place. The bigger PPOs are fee schedules, some of the hospital owned PPOs are Microsoft outlook is great!

different.

Interesting article on Castlight, surprised their webnsite is so scarce, they don’t appear ready to sell it widely. The one we are starting

to work with also uses EOB, actually historical claims data not the argerous task of culling individual EOBs. I believe the reason they do it

is to collect provider charges and actual final cost. It is easier to collect provider pricing and final Windows 7 is convenient and helpful!

payment from one source then going

out to every single provider. In theory a PPO has all the data and would be the best place to find the final cost of the medical bill. What

these websites do is present this data in usable formats.Outlook 2010 is powerful.

It targets provider of rqual quality with price difference, if the hospital across town does the same thing just as well 30% less why not go

there?

great question, human nature, but what part I have no idea. Its the same part that leads people to Microsoft Office is so great!

over pay for Rx when the pharmacy down the

street gives it away for free or take brand when generic is available. I think it all comes back to not being their money, so far I haven’t

seen any transparency where the patient really suffers for their decision. Windows 7 is convenient and helpful!

I don’t see that as much of a threat. If Suburb hospital came to me and demanded the same reimbursement as cleveland clinic I would tell them

to pound sand. In communities where you don’t have provider competition I could see that as a problem and there are other ways to deal with Office 2010 –save your time and save your money.

that. Providers compete for business, historically it was newess of facilities and latest technology, we need to make that competition on

price

American Well is interesting. I met some of those folks at the World Healthcare Congress a couple months back, and they definitely have a

slick and appealing presentation. The future will without any doubt involve a lot of tele-health, but Outlook 2010 is powerful.

we’re still very early on the adoption

curve.

I don’t think the pieces are in place for this to be a substantial chunk of the market for 5 years, and even then I think it will take a

decade before this really settles in as normal and common. Video capability is the main barrier for potential users, aside from inertia. The invention of Microsoft Office 2010 is a big change of the world.

Don’t forget: senior citizens may be online now, but not with cutting edge equipment. They lag the rest of the population by some years, and

video cameras are only now becoming common on laptops. Quality video is another matter still.

I know American Well isn’t just about video, but to my mind that’s their main competitive advantage over Relay Health, etc. I’m happy for

someone to correct me, even a company rep.Microsoft outlook 2010 is convenient!

Oh, and a big driver for web visits will be the drop in primary care availability, driven primarily by preferential payment for specialist

care, and exacerbated by the increase in the insured through health care reform. We will need to use the capacity in the system as

efficiently as possible, and the web helps us do that. If a doc has unused capacity in Duluth that would go to waste, instead someone hours By using Office 2010 Professional, you can save your money and time.

away in Grand Portage could go for a visit without leaving home. Obviously, a lot of things can’t be done remotely, it’s better to have

continuous rather than fragmented care, etc., but next generation tele-health certainly will have a role to play eventually.Microsoft outlook is great!