EHR

Update on EHR

Stay current on the latest information regarding electronic health records.

Scott Jens, O.D., F.A.A.O., MIDDLETON, WISC.

Many O.D.s have been encouraged by the EHR Incentive Program to begin certified EHR product adoption. But lost in this exploration, purchase and implementation venture are the realities of EHR efficiencies and the values of various Meaningful Use (MU) objectives that improve patient care and outcomes.

“We now accept the fact that learning is a lifelong process of keeping abreast of change. And the most pressing task is to teach people how to learn,” Peter Drucker, writer, professor and management consultant once said.

Such is the case with MU objectives. This article teaches you the latest on EHR.

MU update

MU of EHR technology implies that the provider is making an effort to provide patient care that results in:

• Improved care coordination
• Reduced health disparities
• Engaged patients and their families
• Improved population and public health
• Adequate privacy and security

Optometrists are lagging behind general medicine in the adoption of EHR technology and powerful software systems that include EHR.

The MU program kicked off in 2011 with two five-year participation options, in which doctors who committed to MU starting in 2011 or 2012 could receive up to $44,000 through a five-year period of MU. Doctors starting their MU efforts in 2013 are still eligible for up to $39,000 through a four-year program period.

Doctors are allowed an “easy entry” period into their first year of MU by being required to show 90 consecutive days of MU within a calendar year. New MU rules that are in effect as of late 2012 have clarified that doctors will have that easy entry period no matter what year they begin MU. Furthermore, they will be measured to the Stage 1 MU standards even if they begin MU in 2014 while earlier adopters will go on to the Stage 2 MU program.

In 2014, a one-time rule will find all providers being held to a 90-day MU period. Since EHR vendors are being required to certify to new standards by Jan. 1, 2014, the providers are being given this one-time relief so they can upgrade and implement their newly certified EHR technologies.

CMS has made some revisions to MU for 2013’s Stage 1 program. These changes are in effect as of Jan. 1 and must be met for all providers who are qualifying for Stage 1 MU in the future.

► Computerized Provider Order Entry (CPOE). When entering a new medication order in the EHR, the provider will now be graded on the ratio of all EHR-entered meds instead of previous patients.

► Vital signs. Providers may now capture vital signs for only blood pressure, or only height and weight, instead of being measured on capturing all three vital signs together.

► E-prescribing. Providers may be excluded from this key component of MU if they practice more than 10 miles away from a pharmacy that accepts electronic prescriptions.

The Stage 2 criteria for MU have been published and will start on Jan. 1, 2014. The objective of Stage 2 MU is to increase the interoperability of EHRs and the connectedness of providers. Stage 2 MU has 17 Core Objectives (Stage 1 has 15), and a provider must also select three of six Menu Objectives (Stage 1 asks for selection of five from 10.)

When 2014 arrives, providers will be expected to share data with other providers electronically. National secure peer-to-peer e-mail services, such as The Direct Project (directproject.org), will be available for a low fee to allow doctors to share messages, files and reports.

The Stage 2 standards will also expect providers to connect electronically with patients. Two very important requirements: (1) to direct patients to a secure online portal to download, view, or transmit their health data, and (2) for some patients, to send a secure electronic message back to the provider.

These requirements will put the onus on doctors and staff to get patients to a highly engaged status with the practice.

EHR values to optometric business

EHRs provide tremendous value to the business of optometry. Since EHR systems commonly provide full practice management, optometrists can run more efficient and effective businesses beyond the exam room.

The “Three E’s” of value are Economy, Efficiency and Excellence. When implementing EHR, optometrists experience:

► Economy. Using an EHR flat-out saves a practice money. Despite the necessary investment in hardware and software, EHR technology reduces the expense of running a business. The cost of paper charting, moving records within the practice, and inefficiencies of data management is significant.

► Efficiency. When starting, doctors don’t feel more connected to the patient when using an EHR. But the flow of information and improved flow of patients within the practice are measurable and provide a tremendous ROI.

► Excellence. Patients are expecting providers to utilize the newest technologies, including EHRs. They see their care become more seamless, from recall to confirmations to exam room to product purchases.

The time is now

EHR technology is sophisticated and efficient for optometric practices. From effective e-prescribing to improved letter writing to seamless optical orders, EHRs provide solid practice management solutions and excellent exam room documentation.

Given the financial incentives from CMS for adoption, 2013 is the year to choose a vendor and adopt a system. OM

Dr. Jens practices at Isthmus Eye Care in Wisconsin, and is the CEO of RevolutionEHR, a webbased EHR computer application for optometrists. E-mail him at sjens@revolutionehr.com, or send comments to optometricmanagement@gmail.com.