Tuesday, June 23, 2009

News Flash: Mrecord EHR Beta Program

Our Speech Driven EHR is getting ready for Beta customers

We are finally getting ready to take the wraps off our Speech Driven Electronic Health Record systems. Our key focus during the entire development process of our EHR system was:

a) Make it super fast (faster is better than slower)
b) Make it very easy & web 2.0
c) Deliver it through the cloud (anywhere, everywhere, anytime access)
d) Innovate, not duplicate (our collaboration based EHR is first of its kind)
e) Focus on Adoption and try not to turn physicians into Data Entry robots (you can drive the entire EHR by just using Speech)
f) Keep it Open Standards based (we are getting ready to release the API soon)
g) Break all the rules and we have done just that
h) Its not about the technology, its about the users; listen to your customers

Our EHR Beta Program starts 1st August and we are excited. Keep a look out for more information.


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Friday, June 19, 2009

Suggestions on managing personal finances


With the unemployment rate at a 25 year all time high, here are some tips on how to manage your personal finances. I have found this to be useful and thoughts others might too.


[1]Learning to live within your means, however, often requires sacrifice. You’ll need to establish financial priorities (college savings, retirement, money for charitable giving), create a realistic budget, and stick with it. To make budgeting more visual, some financial advisors recommend dividing your monthly income into separate envelopes (or spreadsheets) at the beginning of each month. They should include retirement, mortgage, groceries, gas, utilities, college savings, entertainment, and personal savings.

If the money runs out in any of the envelopes before your next paycheck, you’ll have to borrow from another to make ends meet- most likely entertainment. And if your entertainment fund suffers a shortfall every month? You might have to consider reducing your expenses by purchasing a cheaper car, downsizing your house or giving up some vacation travel.

But look on the bright side: By establishing good spending and saving habits now, you’re not only safeguarding your financial future, but helping to ensure that you won’t have to continue working into your 80s ........ unless you want to.

[1] Physicians Practice January 2009


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Feelin' Lucky?

If you can answer yes, then you are probably in the minority these days. Why? Well...you could/should feel lucky if: 1) You have a job. 2) You have a job and you have health insurance. 3) You don't have a job, but you can afford COBRA. 4) You don't have a job, you have health insurance and you can still afford to pay for your medical care. 5) You're just as healthy as a horse and may not fit in any of the above categories!

This is a real crisis and I'm not sure when or how this will get resolved any time soon. In North Carolina a new unemployment rate was posted today ... 11.1%. That captures alot of folks and some of them probably aren't lucky.

Imagine scheduling surgery for chronic back pain. You're all set. It's day of your surgery. You check into the hospital, insurance card in hand. Then, they tell you, "Your copay for this service is $500!" What? "You need to pay your coinsurance prior to your surgery, or we will have to reschedule your surgery." What would you have to do? Many are rescheduling. Sad, but true fact.

Can you see both sides? I can. On one hand, you've paid your premiums and now you need to use your insurance, but you still can't get the treatment you need. On the other hand, the hospital has bills to pay, payroll to meet, etc. Face it insurance companies pay less and less each year and the patient is expected to pay more and more. Hospitals aren't banks and they need cash to operate. Ditto for the Physicians.

So, now who's the luckiest of us all? Just might be the insurance companies!

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Friday, June 12, 2009

"Meaningful Use" Discussion Rages On

Separating "Meaningful Use" from "Meaningless Use" and the great national experiment

A workgroup of the HIT Policy Committee on June 16 will unveil its recommendations on the definition of "meaningful use" of electronic health records. Whatever the outcome of these discussions & panel group meetings, there is clear consensus that everyone will have to agree to disagree.

In an article by Dr. Justin Graham, he decided to address the question by defining "meangingless use" instead. Here are his suggestions
· The committe EHR implementations that lead to unambiguously worse outcomes for patients without hope of improvement. For instance, increased deaths in ICUs when computerized order entry malfunctions.
· A series of highly visible failed implementations that scare providers (and even patients) from adoption of HIT over the next decade.
· Cynical use of HIT solely to support higher salaries for providers or reduced costs to insurance companies without concomitant improvements in quality of care
· Widespread adoption of technological “dead-ends” that lock providers into proprietary data models and interfaces, eliminating the possibility of future innovation and improvement of the healthcare delivery model

We all agree that Healthcare IT (HIT) has the power to transform the landscape of healthcare in America. But Computerized Physician Order Entry (CPOE) systems are known to fail fantastically. In my opinion the administration should focus on discussing outcomes rather than forcing doctors to use their shiny new EHR in a way that benefits traditional EHR vendors.


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The Health Information Security and Privacy Collaboration (HISPC)

The Health Information Security and Privacy Collaboration (HISPC)

I came across an interesting manual that I feel would be of benefit to all. It was a collaboration that aims to address the privacy and security challenges presented by electronic health information exchange through multi-state collaboration.

All medical practices are faced with the confusion about which product to buy, will it interface with other products in years to come and how it will affect the privacy and security of patient information. Hopefully this manual will be of some assistance in making one of the most important decisions a healthcare provider will make in the next few years.

Here is a brief description from the Health Information Technology website.

Established in June 2006 by RTI International through a contract with the U.S. Department of Health and Human Services (HHS), the Health Information Security and Privacy Collaboration (HISPC) originally comprised 34 states and territories. HISPC phase 3 began in April 2008, and HISPC now comprises 42 states and territories, and aims to address the privacy and security challenges presented by electronic health information exchange through multi-state collaboration. Each HISPC participant continues to have the support of its state or territorial governor and maintains a steering committee and contact with a range of local stakeholders to ensure that developed solutions accurately reflect local preferences.

The third phase, comprises 7 multi-state collaborative privacy and security projects focused on analyzing consent data elements in state law; studying intrastate and interstate consent policies; developing tools to help harmonize state privacy laws; developing tools and strategies to educate and engage consumers; developing a toolkit to educate providers; recommending basic security policy requirements; and developing inter-organizational agreements.

Each project is designed to develop common, replicable multi-state solutions that have the potential to reduce variation in and harmonize privacy and security practices, policies, and laws.


Here is a link to their website and to the manual http://healthit.hhs.gov/portal/server.ptopen=512&objID=1240&parentname=CommunityPage&parentid=2&mode=2

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Hey, are they talking about you? You should hope so!

Everyone is jumping on the social media bandwagon and medicine is no longer a straggler. Social media is effecting medicine in more ways than we can imagine. In the past, medicine relied largely on word of mouth and some physicians advertised. You see these ads all the time in the neighborhood magazines. But now, things are changing. You are not reaching only your selected target group, your scope is much broader than you imagined. All this, thanks to social media networks.

Molly Merrill of HealthcareIT News found that:

According to a recent survey, social media influenced nearly 40 percent of hospital or urgent care center patients. The Spring 2009 Ad-ology Media Influence on Consumer Choice survey found that 53 percent of patients between the ages of 25 and 34 years old were the most influenced by social media. Urgent care and maternity services provide excellent opportunities to connect with younger consumers, and social media is the way to engage this group.
These social networks are not just about finding physicians or hospitals. There is an online site where patients link themselves into social groups by their diagnosis. Here, you are able to communicate with others who have the same diagnosis. Patientslikeme.com allows you the option of taking charge of your healthcare by seeking opinions from members regarding their treatment, medications, surgeries etc.

Physicians are also jumping into social medial marketing. According to an article by Michael Blankenship with PepperDigital:
Surgeons staff are microblogging on Twitter while performing surgery, practicing what can only be described as social media medicine. Why social media in the operating room? The physician remarked that it's to make people aware that there is a procedure to remove a tumor without taking the kidney.
Families are being updated during a surgical procedure via Twitter, not only with those in the waiting area, but family members across the country.

In the past, medicine has been slower than most to jump into technology - EHR is a perfect example. Their scheduling is probably computerized as well as their billing, but charting has been slow to transition. Communication, however, seems to be a different story.

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Thursday, June 11, 2009

HITECH Bill & what it means for Physicians & Medical Offices

New stimulus package for the healthcare sector, and the incentives for electronic health record systems adoption.

The key elements of the HITECH bill are the incentives outlined for the purchase & meaningful use of a certified EHR. Cash incentive offered is up to $44,000 reimbursed as Medicare payments. Payments start in 2011 and end in 2014, and are meant to offset the cost of purchasing & implementing an EHR for physician offices. Readers should note, that at the time of writing this blog-post, that the terms Certified EHR & Meaningful Use are largely undefined and still being worked on.

The focus of this article is more the requirement for demonstrating “Meaningful Use” of the electronic health record. As part of meaningful use, physicians have to demonstrate that they are using the EHR to achieve objectives that the government will lay out in the coming months. The bill also makes its intentions clear that every year the criteria for meaningful use will intensify, requiring clinicians to make greater use of the EHR. Those not achieving will not be eligible for on-going incentives even though they may have qualified for incentives in prior years.

Many physicians I have spoken to feel like an EHR demotes them to being data-entry jockeys and de-humanizes the process of diagnosis and treatment. They do see the advantages of going paperless & having reportable data but shudder at the thought of having to use templates for encounter capture. There are thousands of instances of failed EHR, and their fear isn't unreal. Not surprising many feel that that even if they were to make the plunge and splurge on the purchase they may not qualify on the basis of meeting meaningful use criteria.

However, a system that has worked for eons is clinicians using speech, also known as dictation, as a method of capturing encounter information. Combine that with natural language processing technologies and you get a very rich set of data which can drive information into an EHR, leveraging the many benefits of an EHR.

Therefore, an EHR which uses Speech as the primary form of input, uses natural language processing for driving discrete data and integrates with existing office processes would see the highest adoption & success rates. And with the right speech-to-text provider physician offices can be sure that they will continue to meet meaningful use criteria, whatever that turns out to be at the end of this year.

Mrecord has been working towards that goal for the past many years integrating various cutting edge technologies including voice recognition, & natural language processing. It integrates its cutting edge Speech To Text platform with its Speech driven EHR product, all of it delivered via the cloud. Medical offices don't even have to purchase an EHR and still qualify for the $44,000 incentive.

Could this be the turning point for EHR adoption?

To learn more about our initiative and to participate in it, go to mrecord.com


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Wednesday, June 10, 2009

Rewarding Employees can be very, ehm.. rewarding

Rewarding your employees for providing outstanding customer service is a good incentive to make them want to continue down that same path. It can be something as simple as a pat on the back or an e-mail acknowledging what an outstanding job they are doing. Employees like to be recognized when they are doing a great job but a lot of times, supervisors tend to focus on the bad. The focus should be on both.

Many professional associations have weeks or even months that recognize employees in that profession. Some of these include Health Information and Technology (HIT) week, which is sponsored by the American Health Information Management Association (AHIMA). The third week in May is recognized as National Medical Transcriptionist Week by the Association for Healthcare Documentation Integrity (AHDI). The month of March is recognized as Social Work month by the National association of Social Workers (NASW). There is also Administrative Professional Day. During these weeks or months, employers will recognize their employees by taking their staff to lunch, having contests or bringing in bagels, juice and coffee.

Your employee’s ideas and comments should always be welcome. They are the ones that are in the front line and are normally the first point of contact. By doing this, the employee will feel appreciated and that their thoughts and ideas are important.

This will go a long way with employee retention.
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Friday, June 05, 2009

Customer Service and Healthcare

Customer service is the backbone of any company. You need to train your employees on how to provide outstanding customer service. And the training should be on-going. Customers not only include your patients or someone that may be paying for a service that you provide, it also includes your internal staff. You may not realize it but when you answer the phone, the person on the other line can tell if you are smiling or not.

Your employees should enjoy their job and what they do. They should have a satisfying feeling when they leave work at the end of the day and know that by listening to a customer or a patient complain, no matter what it is about, made that person complaining feel like someone really cared.

Going the extra mile would be to resolve or assist in resolving the complaint. Sometimes we have to go above and beyond in what we do with our customers. Wouldn’t you like to be treated the same way?

Just remember, without customers, you would not be in business.

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EHR Implementation

Don’t groan! We all know that it can be painful. But, it doesn’t have to be. Once you’ve chosen a company just be sure to ask all the right questions. Become knowledgeable of all the steps involved in implementation, training and support. Be prepared. Do your homework. Get everyone’s buy in. Don’t skimp on training or support. One of the keys to a successful implementation is allowing the company to be on site for implementation and training. Don’t try to do this yourself. They are the experts, capitalize on this resource. Big changes will happen for the better.

Envision no more pulling, filing or tracking down charts – what a great world it will be!

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Managed Care Contracting - get some help, NOW!

Ugghh! Is it just me or are these contracts getting longer and have more and more plans attached to them? I’m beginning to feel that the amount of pages is in direct correlation to the amount of physician dollars they intent to keep. Time frames are shortening, the amount you can collect from the patient is obscure and the hoops that need to be jumped through are increasing. Managed care contracting shouldn’t be such a nightmare, and it really isn’t. Practice managers just don’t have the time to wade through the pages, delve into the research, crunch all the numbers and take on the challenge in a normal office day. More and more practices are seeking outside help from contracting groups to help with these issues. Groups need advocates to negotiate the best rates and terms for all their hard work. Hiring a managed care consultant is no longer a luxury, it’s almost a necessity.

So, when the next contract comes in, take the time to think about whether you want to just cave in and sign or really have someone fight for your best interests.

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Benefits of SaaS in Healthcare

SaaS is not just a new software jargon; it radically changes how we buy, use & access software today.

SaaS is short for “Software-as-a-Service”. So first let’s talk about what SaaS really means. SaaS is software solution hosted and supported by a solution provider as a service, and accessed by users via the Internet, without the need to deploy and maintain an on-site IT infrastructure. Generally it also means that you never actually buy the software, you almost always subscribe to it for a small fee.

Some everday examples of SaaS are popular free email services like hotmail, yahoo mail and gmail.

SaaS in healthcare is comparatively a new concept. Most HIT vendors use 90's technology (last century) which they dump onto big servers running on software which require expensive licenses and they sell it to you for a number which isn't for the squeamish. To run & operate these behemoths you need IT staff at your office, special server closets/rooms, and multiple (expensive) T1 lines connecting your various offices.

If your head hasn't started to spin yet, then wait till you hear this. You are also required to protect & backup your data, and when it goes down, your entire office comes to a stand-still, while your HIT vendor works on fixing the problem.

SaaS on the other hand does things entirely differently, allowing healthcare providers, practices, and hospitals to use the application suite without having to invest the upfront capital in implementing the solution. This lets healthcare IT focus on more strategic initiatives, rather than reacting to application availability, maintenance and support issues.

This delivery model offers numerous benefits to healthcare customers:

1) Eliminates the need for costly server hardware, server licenses and network infrastructure at the client location. The client only needs inexpensive internet connectivity to access the application. With no hardware or software to manage you reduce your need to invest in dedicated engineers to support this infrastructure. The SaaS provider is the one with all the headaches.

PS: Most SaaS providers will provide SLA (Service Level Agreements) and in the event of any downtime, you can hold their feet to the fire. For instance Mrecord offers a 99.99% uptime, which roughly translates to under 1 hours of downtime a YEAR.

2) Shorter deployment time lines. No waiting for hardware/software provisioned or need to schedule time for installation, it is as close to plug and play as you can get. You can typically start the same day you decide to go-live (of course you still need training & have to orient your team to changed workflow but I wont go into that here). That is something traditional HIT vendors can ever dream off. Your SaaS provider is ready when you are since the server and network infrastructure is already in place for their other customers. So you only have to focus on your workflow/proceses during the deployment phase, significantly reducing the time and resource requirement from your side to implement.

3) Application is available Anywhere, Anytime, Any place is the true miracle of SaaS. Your healthcare SaaS application can be securely accessed over the internet and used anywhere that an internet connection is available- whether at the facility, over a cellular network, at home, or even the local coffee shop. Traditional HIT providers will tell you that their software can be accessed via VPNs & Internet, but dont tell you that it will cost you thousands in additional licensing costs from third-parties to enable it. SaaS does it right out of the box.

4) Software updates. This is my favorite part. As I have seen with my own healthcare clients, the day a new update is to be done to their HIT software, the office feels like a bomb is being diffused. Fortunately there is no such drama with SaaS. The updates are done by the SaaS provider (they generally middle of the night so their clients don't even have to stop work during working hours) and this comes in the form of frequent, consistent software updates over time. Plus with SaaS you almost never pay for any updates or yearly maintenance fees (yes really!), it is in best interest of the SaaS provider to continually improve the solution experience.

5) Reduce your IT Pains. Let’s face it- traditional client/server software applications require a significant human investment to succeed, but a SaaS solution offloads a great deal of the IT pains incurred by software consumers. This lets your IT resources focus on improving the day-to-day technical operations instead of troubleshooting 3rd party software or maintaining aging infrastructure.

6) Unlocks Return on Investment. With SaaS, you pay as you go. Which means the impact to the bottomline is immediate. You dont have to wait years to see a breakeven on your investment. With SaaS you also limit your exposure to the length of the contract (many SaaS providers are allowing their customers to go month-to-month as well). So if the application isn't right for you, you simply take your data to another provider and start there. With Traditional you are stuck with a white elephant and most people end up having to use it even if they find it just plain unusable.


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