July 3, 2011, is the final deadline for eligible hospitals to begin the 90-day reporting period to demonstrate meaningful use under the 2011 Medicare EHR Incentive Program. That means you have only four days left to begin the reporting period.

As a quick refresher, here is information about the Medicare EHR Incentive Program (via the CMS page about the program):

The Medicare EHR Incentive Program will provide incentive payments to eligible professionals, eligible hospitals, and CAHs that demonstrate meaningful use of certified EHR technology.

• Participation can begin as early as 2011.
• Eligible professionals can receive up to $44,000 over five years under the Medicare EHR Incentive Program. There’s an additional incentive for eligible professionals who provide services in a Health Professional Shortage Area (HSPA).
• To get the maximum incentive payment, Medicare eligible professionals must begin participation by 2012.
• Incentive payments for eligible hospitals and CAHs may begin as early as 2011 and are based on a number of factors, beginning with a $2 million base payment.
• For 2015 and later, Medicare eligible professionals, eligible hospitals, and CAHs that do not successfully demonstrate meaningful use will have a payment adjustment in their Medicare reimbursement.

Further dates that we recommend our clients, and any eligible professionals or hospitals interested in maintaining compliance, mark on their calendars:

September 30, 2011: End of reporting year ends for eligible hospitals and critical access hospitals (CAHs) for 2011 Medicare EHR program.

October 3, 2011: Last day for eligible professionals to begin their 90-day reporting period for calendar year (CY) 2011 for Medicare EHR Incentive Program.

November 30, 2011: Last day for eligible hospitals and CAHs to register and attest to receive an incentive payment for fiscal year 2011.

December 31, 2011: Reporting year ends for eligible professionals.

February 29, 2012: Last day for eligible professionals to register and attest to receive an incentive payment for CY 2011.

IDMS can help your hospital or medical practice keep track of CMS deadlines and requirements to maintain compliance. Our goal is to maximize CMS and other payor reimbursement by assisting our customers in providing evidence-based, quality patient care and accurately documenting that care. Please call IDMS today at 972-922-9800, or email us at integrateddatamgmt@gmail.com.

In the first segment of this series, we discussed why data backup is vital for compliance. Today, we will discuss the types of data backup that are available.

What Type of Data Backup Should I Use?

A wide variety of options are available for backing up your data. You should keep at least one encrypted copy of your data, and be sure that it is stored off-site. And make sure that regular, scheduled backups occur so that large chunks of data are not lost. The best option is paying for a service such as Carbonite, which will store your data in a safe, remote site. You can also purchase an external hard drive, rewritable CD-ROMS, or USB drives to store your encrypted files on. If you choose one of these options, you should be sure that a trusted employee removes the drives or discs from the office every night to be sure that they are not stolen or harmed.

Now that you understand the need for data backup, and the options for backing up your data, take the steps to implement a data backup plan. You will benefit from it, as will your patients.

The Integrate Data Management Systems staff has over 50 years of combined experience and can easily understand and interpret CMS policies to improve compliance, office efficiency, and patient care. Contact IDMS today at (972) 922-9800, or email us at integrateddatamgmt@gmail.com to schedule a consultation.

Why Is Data Backup Important?

Patient health records are integral to properly caring for patients. The information serves as a point of referral for past health conditions as well as the treatment prescribed for those conditions.

You also need to secure patient records to stay compliant to government regulations. HIPAA guidelines, for instance, require providers to instate disaster recovery plans which include details about what precautions and actions will be taken in cases of specific situations, such as fire, robbery or vandalism, natural disaster, or complete power failure. Without proper backup, all of your records could be lost in such situations, which can not only affect your HIPAA compliance but your CMS compliance as well.

Next time, we will discuss the types of data backup that are available.

The Integrate Data Management Systems staff has over 50 years of combined experience and can easily understand and interpret CMS policies to improve compliance, office efficiency, and patient care. Contact IDMS today at (972) 922-9800, or email us at integrateddatamgmt@gmail.com to schedule a consultation.

According to a study of nearly 14,000 elderly patients, when the emergency department (ED) nearest to a patient experienced diversion for 12 hours or longer, patient mortality rates were higher at 30 days, 90 days, nine months, and one year than when the ED was not on diversion.

Authors of the study noted that diversion is a sign of a bigger problem with access within the health care system. Ambulance diversion affects both patients being diverted and patients not diverted who had to wait in a hospital on diversion. Diversion of EDs occurs when the EDs are crowded with patients in hospital beds and waiting rooms, and crowded EDs have trouble caring for every patient.

“A task force of emergency physician experts ha[s] proposed solutions to crowding and ambulance diversion, and hospitals can implement them now,” said Dr. Sandra Schneider, president of theAmericanCollegeof Emergency Physicians. “The key is increasing flow through emergency departments by moving patients who have been admitted to the hospital out the emergency department to inpatient areas.”

The task force’s recommendations include:

• Move admitted patients out of the ED to inpatient areas. When each unit takes a small number of patients, the burden of boarding is more evenly distributed, thus enabling the ED to care for emergencies better—without unduly stressing inpatient units.
• Coordinate hospital patient discharges before noon. Timely departure from the hospital can significantly improve the patient flow in EDs by freeing up more inpatient beds to emergency patients.
• Coordinate elective patient and surgical case scheduling. An uneven influx of elective patients (usually heaviest early in the week) is a major contributor to exceeding capacity, often requiring support services to be available seven days a week.

The study’s authors could not pinpoint the exact diversion mechanisms that affect patient outcomes, but they found that when the nearest ED is on diversion, the proportion of patients admitted to hospitals with catheterization capacity is lower. They said the findings emphasize the need for targeted interventions to appropriately distribute system-level resources to decrease crowding and diversion.

When you outsource your data abstraction with Integrated Data Management Systems, or come to us to train your staff, we can help you streamline your record-keeping to free up your professional staff to focus on better patient care. Contact IDMS today at (972) 922-9800, or email us at integrateddatamgmt@gmail.com to schedule a consultation.

Thanks to EHR Watch for their information.

We will focus on two questions, both regarding specifics for reporting cases in which a patient was not seen by the eligible professional (EP), but by another member of the staff.

Determining If a Patient Has Been “Seen By the EP”

This first question was posted on June 6, 2011 at 9:58 a.m. (and updated at 10:48 a.m.). The full question is as follows:

For the Medicare and Medicaid EHR Incentive Programs, how does an eligible professional (EP) determine whether a patient has been “seen by the EP” in cases where the service rendered does not result in an actual interaction between the patient and the EP, but minimal consultative services such as just reading an EKG? Is a patient seen via telemedicine included in the denominator for measures that include patients “seen by the EP”?

CMS responded by saying that any case in which an EP and a patient physically interact and during which they render any service to the patient should be included in the denominator as “seen by the EP.” Patients seen through telemedicine would also count as “seen by the EP.” In cases where the EP and the patient do not meet in person or via telemedicine, but the EP provides a minimal consultative service (like reading an EKG), the EP can choose whether to include patient in the denominator as “seen by the EP.” That choice must be consistent for the entire EHR reporting period, and for all relevant meaningful use measures. For instance, a cardiologist may choose to exclude patients who receive a one-time reading of an EKG sent to them from another provider, but include those who receive more involved consultative services, but the policy must be applied to the entire EHR reporting period and for all meaningful use measures that include patients “seen by the EP.”

In cases of EPs who never have a physical or telemedicine interaction with patients, a policy that classifies at least some of the services they render for patients as “seen by the EP” must be adopted, and the EP must apply the policy to the entire EHR reporting period and across meaningful use measures that involve patients “seen by the EP”—otherwise, these EPs would not be able to meet meaningful use standards, as they would have denominators of zero for some measures.

Patients Seen Only By the EP’s Clinical Staff During the EHR Reporting Period

CMS also posted the second question on June 6, but at 10:10 a.m. (with an update at 10:51 a.m.):

For the Medicare and Medicaid EHR Incentive Programs, when a patient is only seen by a member of the eligible professional’s (EP’s) clinical staff during the EHR reporting period and not by the EP themselves, do those patients count in the EP’s denominator?

This much less weighted question allowed for a succinct answer:

The EP can include or exclude those patients in their denominator at their discretion as long as the decision applies universally to all patients for the entire EHR reporting period and the EP is consistent across meaningful use measures. In cases where a member of the EP’s clinical staff is eligible for the Medicaid EHR incentive in their own right (NPs and certain physician assistants (PA)), patients seen by NPs or PAs under the EP’s supervision can be counted by both the NP or PA and the supervising EP as long as the policy is consistent for the entire EHR reporting period.

IDMS can ensure that your patient records are accurate and consistent, meeting all meaningful use standards during any given EHR reporting period. Our staff has over 50 years of combined experience and can easily understand and interpret CMS policies to improve compliance, office efficiency, and patient care. Contact IDMS today at (972) 922-9800, or email us at integrateddatamgmt@gmail.com to schedule a consultation.

According to the proposal, any organization requesting data would “generally be required to use standard measures for evaluating the performance of providers of services.” National Quality Forum indicators, which CMS uses on its Hospital Compare website, would likely be included in the measures. Hospital Compare rates hospitals according to criteria like 30-day mortality rates, patient outcome, readmission rates, and use of antibiotics in inpatient surgeries. The organizations would not have access to specific patient information; therefore it would not be included in their reports.

Currently, organizations must rely on data from private insurers to measure quality of care. The proposed rule would expand the ability to accurately depict quality of care. Hospitals, physicians, or providers singled out in a report would have an opportunity to respond to any care report before its release.

The goal of the proposed rule is to improve the quality of healthcare in theUnited Statesand make healthcare more affordable. As a healthcare provider, it is important that you keep your data accurate and organized to give the best possible representation of your quality of care.

Integrated Data Management Systems can help ensure that your data is organized to give you the most accurate, positive reviews possible.

The experts at IDMS have over 50 years’ combined experience in hospital administration and data abstraction. IDMS works with public and private healthcare organizations to maximize CMS reimbursement by providing accurate documentation and analysis. Once the data is compiled, IDMS will develop an implementation strategy to improve compliance. Contact IDMS today at (972) 922-9800, or email us at integrateddatamgmt@gmail.com to schedule a consultation.

Physicians who currently use a qualified e-prescription system are eligible to receive additional Medicare Part B payments: 1 percent in 2011 and 2012, and 0.5 percent in 2013. Providers who do not complete at least10 e-prescriptions with a qualified system between January 1 and June 30, 2011 will receive cuts in Medicare reimbursements: 1 percent in 2012, 1.5 percent in 2013, and 0.5 percent in 2014.

Under the original rule, exemptions to the e-prescription transitions and penalties include physicians who practice in rural areas without sufficient high-speed Internet access, and physicians in areas without enough available pharmacies. The recent proposed rule extends the exemptions and allows doctors who cannot e-prescribe for other reasons to apply for “hardship exemption” by October 1, 2011 via a new government website.

The new proposal would also extend the definition of “qualified” eRx prescribing systems in the original measure to include certified EHR technology. Under the new rule, eligible professionals (EPs) and groups who participate in e-prescribing could choose between a qualified e-prescribing system and certified EHR technology.

CMS will continue to push theU.S.medical field into an entirely paperless record system, but the new proposal could help ease the transition for many physicians. Making sure that you make the transition soon will help secure early and accurate reimbursements and will prevent penalties. Integrated Data Management Systems can help you make the transition by ensuring efficient, accurate data recording within your medical practice or hospital.

The experts at IDMS have over 50 years’ combined experience in hospital administration and data abstraction. IDMS works with public and private healthcare organizations to maximize CMS reimbursement by providing accurate documentation and analysis. Once the data is compiled, IDMS will develop an implementation strategy to improve compliance. Contact IDMS today at (972)22-9800, or email us at integrateddatamgmt@gmail.com to schedule a consultation.

Though HIPAA’s deadline to switch from  ICD-9 to ICD-10 is October 1, 2013, over two years from now, hospitals need to begin preparing for the transition right away. But the CMS deadline for qualified participants to switch to X12 Version 5010 and NCPDP Version D.0 is January 1, 2012 (with some exceptions). Version 5010 includes the ICD-10 coding, but the compliance deadline is earlier to allow the industry proper time to test the system’s efficacy.

Under ICD-10, the number of diagnostic codes will increase from the current 13,000 to 68,000, and the number of characters in the code will increase from five to seven. The goal of the coding change is to gather more accurate diagnostic information. With more accurate data, health care professionals and hospitals can better navigate claims data and provide better patient care.

More accurate data will also allow for more precise PQRS and eRx filing, which could mean larger and faster incentive returns. The earlier that you prepare for the new coding system, the earlier you can start reaping benefits.

Integrated Data Management Services (IDMS) can help ease the transition to ICD-10, Version 5010, and Version D.0 by improving the way you collect, analyze, and report data.

IMDS assists Dallas/Ft Worth physicians in capturing benefits of PQRS by identifying and correcting problematic areas. Through data abstraction and analysis, hospitals and physician offices can cut costs, improve quality of care, and reduce risk. Once the data is compiled, IDMS will develop a training and implementation strategy to improve compliance. Contact IDMS today at (972)922-9800, or email us at integrateddatamgmt@gmail.com to schedule a consultation.

CMS recently updated the solution to that problem, which was originally published in 2007 in the FAQs section of their website. Satisfactory PQR will be assessed by each individual eligible professional who is part of an NPI/TIN, using the individual-level NPI. The individual incentives earned by members of a group practice will be combined and paid to the TIN under which the claims were submitted. Therefore, whether one or several physicians file satisfactory PQR, the entire group will receive the incentives.

As our last blog post (about PQRS paying off for physicians) reported, nearly 120,000 physicians in more than 12,000 practices received payments from the Physician Quality Reporting System (PQRS), for a total of $234 million in 2009. Stronger participation in PQRS also gives CMS better information about the quality of care for patients in the U.S. and can therefore help improve care for all patients.

Although your entire practice will benefit from just one member turning in satisfactory PQR, it would be even more beneficial—for the practice, the medical field, and for patients seeking care—if every member of the practice participates in PQRS.

Integrated Data Management Services (IDMS) assists Dallas/Ft Worth physicians in capturing benefits of PQRS  by identifying and correcting problematic areas. Through data abstraction and analysis, hospitals and physician offices can cut costs, improve quality of care, and reduce risk. Once the data is compiled, IDMS will develop a training and implementation strategy to improve compliance. Contact IDMS today at (972)922-9800, or email us at integrateddatamgmt@gmail.com to schedule a consultation.

Participation in PQRS has grown approximate 50% each year since the program began. On average, 2009 bonus payments for PQRS were $18,525 per practice and $1,956 per eligible physician. E-prescribing paid out $14,501 per practice and over $3,000 per eligible professional. Physicians and other eligible professionals received payment in the fall of 2010.

As PQRS physician participation increases, CMS will be able to collect more information about patient quality of care. Based on reported data, providers have improved the frequency at which they deliver recommended care by 3.1%, on average. CMS Administrator, Donald Berkwick, MD, explained, “Most beneficiaries get their care in the physician office; however, this is the care setting for which we have the least amount of data about quality of that care. The Physician Quality Reporting System and the e-prescribing program help bridge the knowledge gap so we can better understand the care millions of patients receive from physicians and other care providers every day.”

Integrated Data Management Services (IDMS) assists Dallas/Ft Worth physicians in capturing benefits of PQRS  by identifying and correcting problematic areas. Through data abstraction and analysis, hospitals and physician offices can cut costs, improve quality of care, and reduce risk. Once the data is compiled, IDMS will develop a training and implementation strategy to improve compliance. Contact IDMS today at (972)922-9800, or email us at integrateddatamgmt@gmail.com to schedule a consultation.