Challenges and Forces Driving Adoption

Of Health Information Technology and

Electronic Healthcare Records

Michael D. Paquin, FHIMSS

www.mdpgrp.com

In this segment on Electronic Healthcare records, being sponsored by Physicians Office Resource, we will look at: 

eRX Incentives updates, and Six steps to a successful EMR implementation.

2009 Electronic Prescribing (eRx) Incentive Program Update

The Centers for Medicare & Medicaid Services (CMS) is pleased to announce that incentive payments for the 2009 Electronic Prescribing (eRx) Incentive Program were made to eligible professionals who met the criteria for successful reporting.

The 2009 eRx incentive payments are currently being processed and distributed by Carriers and Medicare Administrative Contractors (MACs). Distribution of the 2009 eRx incentive payments were completed by October 22, 2010.

E-prescribing incentives earned by individual participating physicians and other eligible professionals are paid as a lump-sum to the Taxpayer Identification Number (TIN) under which the EP’s claims were submitted. It is then up to the TIN to decide how to distribute the incentive within the practice.

Effective January 2010, CMS revised the manner in which incentive payment information is communicated to eligible professionals receiving electronic remittance advices. CMS has instructed Medicare contractors to use a new indicator of LE to indicate incentive payments instead of LS. LE will appear on the electronic remittance advice. Additionally the paper remittance advice will read “This is an eRx incentive payment.”  It will not include the year and indicator LE in the paper remittance.   In an effort to further clarify the type of incentive payment issued (either PQRI or eRx incentive), CMS created a 4-digit code to indicate the type of incentive and reporting year. For the 2009 eRx incentive payments, the 4-digit code is RX09. This code will be displayed on the electronic remittance advice along with the LE indicator. For example, eligible professionals will see LE to indicate an incentive payment, along with RX09 to identify that payment as the 2009 eRx incentive payment. 

2009 Electronic Prescribing (eRx) Incentive Program Feedback Reports

The 2009 eRx feedback reports will be available on the Physician and Other Health Care Professionals Quality Reporting Portal at http://www.qualitynet.org/pqri on the internet, starting the second week of November. TIN-level reports on the Portal require an Individuals Authorized Access to CMS Computer Services (IACS) account. Participants may also contact their Carrier or MAC to request individual NPI-level reports via an alternate feedback report fulfillment process, please visit http://www.cms.gov/MLNMattersArticles/downloads/SE0922.pdf on the CMS website.

Who to Contact for Questions?

If you have questions about the status of your eRx incentive payment (during the distribution timeframe), please contact your Provider Contact Center. The Contact Center Directory is available at http://www.cms.gov/MLNProducts/Downloads/CallCenterTollNumDirectory.zip on the CMS website.

Feel free to contact the QualityNet Help Desk with any of the following:

• Physician Quality Reporting Initiative (PQRI) Portal password issues
• PQRI/eRx feedback report availability and access
• PQRI-IACS registration questions
• PQRI-IACS login issues

Six Steps to a Successful EMR Implementation

1. Set up the EHR to fit within staff workflows
'You cannot implement the system to meet 100% of each individual’s needs, but neither can you implement it  in a generic manner and assume that everyone will adjust, the EMR must be adjustable and any good program is adjustable. It is important to determine which aspects can be adapted to work on an individual basis, and which aspects can work across a wider spectrum. Securing the opinions and recommendations of the staff - as well as their cooperation and commitment - are crucial to making sure the EHR will work for everyone.

2. Identify ways the EHR could potentially fail in order to prevent problems in the future
Gather input from the key members of your staff to pinpoint ways the EHR could fail, and use that knowledge to determine what it will take for the EHR to be successful. 'Remember that you are dealing with huge amounts of data. Be sure to allow for enough storage and fast enough computers to quickly access the data.  Implement a backup system from the beginning.

3. Don’t rush implementation, take time to train
'Train for every step of the process and do several short training sessions.  Beginning with the basics is important, and to follow a planned-out procedure so as to ensure the accuracy and efficiency of implementation. Take uninterrupted time for training… you cannot learn an EMR between seeing patients.

4. In EHR implementation, practices are not extensions of the hospital
Practices and hospitals have very different requirements for EHRs.  It is important that you invest not only your time and money in a system that really works for your practice.  It is very rare that the processes that bring success to hospitals will work for a medical practice.  A Hospital EMR might very well create failure in medical practices.”

5. Eliminate duplication
Redundant data entry must be minimized. “Patient demographics, as an example, need to be input at whatever point the patient enters the system, but those demographics need to be available throughout all modules and interfaces, including your diagnostic test results

6. Work with experts who have EHR implementation experience.  Or you don’t know what you don’t know!
Get assistance from someone who has experience in successfully implementing EHR systems. Someone who 'intimately knows the basic workflow of a practice or hospital, and is knowledgeable in the details of the EHR... can make the difference in success or failure.