Demystifying EHR
 

By Masa Pettit
TOA Marketing and Communications Director

The world of healthcare is changing and one aspect of that change is the adoption of EHR (electronic health record) technology to the majority of healthcare practices over the next few years. EHR is also referred to as electronic medical record or EMR. TOA staff is attempting to demystify the complexity surrounding EHR implementation. We hope to simplify some of the issues surrounding the medical electronic health record incentive payments and provide some useful tips for TOA members that are looking to implement or upgrade an existing EHR.  For those eligible providers (EPs) wanting to take advantage of the upcoming incentive payments…the time to act is now. Many EHR vendors are experiencing long waiting periods for new customers and the demand will likely be greater than the supply for the next couple of years.

Furthermore, The IRS has extended Section 179 and made it bigger and better. An increase of the total amount available for deduction to $500,000 (up from $250,000) and an increase to the total amount of equipment purchased to $2 million (up from $800,000). The above numbers are to be in effect for 2010 and 2011. In addition, the bill also extended the 50% bonus depreciation to tax year 2010.

Earlier this year Section 179 was rescinded, but was recently restored. Section 179 of the IRS tax code allows businesses to deduct the full purchase price of qualifying equipment purchased or financed during the tax year. That means that if you buy (or lease) a piece of qualifying equipment, you can deduct the full purchase price from your gross income. It's an incentive created by the U.S. government to encourage businesses to buy equipment and invest in their organizations. You can read more here. Ask your accountant about Section 179.

The American Recovery and Reinvestment Act (ARRA) became a law in February 2009. The stimulus is not connected to the Health Care Reform Act and legislation. Under the part of the stimulus plan referred to as the HITECH Act, eligible providers can qualify for up to $44,000 in Medicare or $63,750 in Medicaid incentives if they demonstrate meaningful use of a certified EHR beginning in 2011. There are two payment options to providers regarding EHR incentive dollar qualification: either Medicare or Medicaid.

EPs may not receive EHR incentive payments from both the Medicare and Medicaid programs in the same year. In the event an EP qualifies for EHR incentive payments from both the Medicare and Medicaid programs, the EP must elect to receive payments from only one program and may only switch between the two programs once, prior to 2015, after receiving an incentive. Furthermore, an EP who selects Medicaid must only receive incentive payments from one state in any payment year.

Medicare Eligible Providers

Under the Medicare program eligible providers are awarded an additional 75% of your allowable Medicare charges, up to a yearly maximum. The total that is available under this option is $44,000 awarded over 5 years for each eligible provider in your practice. Additionally, if a practice fails to implement an EHR and satisfy meaningful use requirements by 2015, they will begin to receive reduced payments from Medicare until the proper implementation takes place. This reduction will increase every year that the practice fails to demonstrate meaningful use of a certified EHR system.

Medicare Payment Schedule

Important note: All eligible hospitals and Medicare eligible professionals must have a National Provider Identifier (NPI), and be enrolled in the CMS Provider Enrollment, Chain and Ownership System (PECOS) to participate in the EHR incentive program. Most providers also need to have an active user account in the National Plan and Provider Enumeration System (NPPES). CMS will use these systems' records to register for the program and verify Medicare enrollment prior to making Medicare EHR incentive program payments.

Medicaid Eligible Providers

To be eligible to participate in the Medicaid EHR incentive program, an EP must either: (1) Meet certain Medicaid patient volume thresholds or (2) practice predominantly in an FQHC or RHC where 30 percent of the patient volume is derived from needy individuals. An exception to this rule is that a pediatrician may have at least 20 percent Medicaid patient volume and still qualify, but at a reduced incentive.

Medicaid Payment Schedule

What is meaningful use?

The requirements of meaningful use to qualify for incentive payments were released on July 13, 2010.The final rule definitively outlines all the specifics of Stage 1 meaningful use and clinical quality measure reporting to receive the incentive payments in 2011 and 2012.

The Recovery Act specifies three main components of meaningful use:

• The use of a certified EHR in a meaningful manner (e.g.: e-Prescribing);

• The use of certified EHR technology for electronic exchange of health information to improve quality of health care; and

• The use of certified EHR technology to submit clinical quality and other measures.

The definition of meaningful use harmonizes criteria across CMS programs as much as possible and coordinates with existing CMS quality initiatives. It also closely links to the certification standards criteria in development by the Office of the National Coordinator (ONC) and provides a platform for a staged implementation over time.

Jennifer Kinman, the COO of Texas Orthopedics in Austin, TX , has generously provided TOA members with a summary of meaningful use criteria, please click here to view. There are two different lists, one labeled "Core Set" and the other "Menu Set." All practices must meet the "Core Set" requirements, but only need to choose five of the objectives from the "Menu Set" in order to qualify.

How do I determine if an EHR is certified?

Remember that eligible providers can only qualify for up to $44,000 in Medicare or $63,750 in Medicaid incentives if they demonstrate meaningful use of a certified EHR.

In order to qualify for Medicare and Medicaid EHR incentive payments, providers must use EHR technology that has been certified by an Office of the National Coordinator for Health Information Technology-Authorized Testing and Certification Body (ONC-ATCB, or ATCB). The temporary certification program provides assurances that the EHR technology adopted by health care providers is technically capable of supporting their efforts to achieve meaningful use. The temporary certification program will be in effect until the permanent certification program is in place. The ONC anticipates that certifications issued under the permanent certification program will occur no earlier than January 1, 2012.

The ONC-ATCB certification has been developed by the federal government to certify that an EHR system meets the technical requirements needed for a provider to become a meaningful user of an EHR system. The use of an ONC-ATCB certified product is required to receive any federal government incentive money for the use of an EHR system. The ONC-ATCB certification test script is very specific to EHR criteria that qualified providers must meet in order to participate in the government incentive program.

The following organizations have been selected as ONC-Authorized Testing and Certification Bodies (ATCBs) through the temporary certification program at this time:

• Certification Commission for Health Information Technology
  (CCHIT) - Chicago, Ill.
  Date of authorization: September 3, 2010.
  Scope of authorization: Complete EHR and EHR Modules.

• Drummond Group, Inc.
  (DGI) - Austin, Texas.
  Date of authorization: September 3, 2010.
  Scope of authorization: Complete EHR and EHR Modules.

• InfoGard Laboratories, Inc.
  San Luis Obispo, CA
  Date of authorization: September 24, 2010.
  Scope of authorization: Complete EHR and EHR Modules.

Two Main Types of EHR Technology

Client Server (C/S) Systems and Software as a Service (SaaS) are the two main types of EHR technologies. A Client Server (C/S) System would typically reside at your office. With the Client Server systems, there is a software license fee, usually per EP as soon as you install the system. Additionally, there can be yearly maintenance costs to cover upgrades, patches, fixes, and customer support. The practice purchases the servers that the software resides on, as well as the individual computers, printers, and scanners in the exam rooms and offices. Your IT professionals are responsible for maintaining the servers and individual computers, including upgrades, operating system patches, security patches, backups, and data security. The startup costs of C/S system are higher initially than the other type of EHR technology; Software as a Service (SaaS), but over time could actually be lower than the SaaS.

Software as a Service (SaaS) is the second EHR technology to consider. With SaaS, you pay a monthly subscription fee, usually per EP, for as long as you use the EHR. There are no servers to buy on which to load software. The EHR vendor will install new software versions, new features, upgrades, fixes or patches as necessary. Your practice is only responsible for purchasing the individual computers, printers, and scanners, for your exam rooms and offices. The start up costs for the SaaS model are lower than with C/S systems, as your organization will not need to purchase the software license or purchase hardware servers and backup systems. The vendor will take care of backing up and securing patient data. 

There are advantages and disadvantages to both EHR technologies. If you are a smaller practice that needs to minimize initial costs, don't have the staff to maintain servers, and would be able to conform to a narrow option of workflows then SaaS would be a consideration. However, if you are considering SaaS, it is very important that you have a contract that indicates clear ownership of the patient data and how your practice can access it.  For larger practices that are looking for a customized EHR, that want to maintain complete control over patient data, and can afford the initial costs of the C/S system where ownership will save money in the long run, then the Client Server (C/S) System would be a consideration.

Tips to Selecting an EHR Solution

• Identify the key decision makers for the EHR selection. The selection team should include a variety of participants who have an impact on EHR implementation. Having a physician champion is best to ensure the practice is committed to the selection and implementation of the EHR. This team should define what you expect the EHR to accomplish for your practice. Ask the question "What types of functionality does the practice need and what is the priority of the functionality desired?" Make sure to allow for changes in workflow. Include a timeline and a budget. It is very important that your practice is committed to the selection and implementation of the EHR to ensure a successful implementation. If there is not a consensus, evaluate and attempt to address the issues.

• Develop a request for proposal (RFP). There are many sample RFP templates available on the Internet. The RFP provides background information on your practice and the types of EHR functionalities needed by your staff. By having this RFP, each vendor will respond to the same series of questions which allows for easier evaluation of the vendor responses. Identify the vendors that you want to include in the selection process. There are some basic items to consider that will allow you to minimize your list. Choose vendors that have interfaces to your current practice management system and also ones that offer a product for your practice size and specialty. Look at vendor evaluations to see which ones have more favorable ratings. One vendor rating system is KLAS, an independent research group that evaluates healthcare technology "by honestly, accurately, and impartially measuring vendor performance". Click here to visit their website.

• RFP Review process. Start researching options ASAP!  Review each RFP response and rank them individually. Have each person on the selection team participate in the review/ranking process, then compile the answers and narrow the list down to the top two or three vendors. Hold vendor demonstrations and allow the vendors to demonstrate their product. Provide the vendors with typical scenarios that you experience in your day to day practice and include items you would like to see improve. Check at least three references for each vendor. Speak with a variety of people from the reference site, such as a physician, an office manager, and someone on the IT staff to give you a well rounded view of the vendor. Include questions for support, training, implementation, etc. Support, training and implementation are critical! Make sure you select a vendor that will meet your needs in these critical areas!

• Decision time. Rank the vendors in order of selection. This is a group ranking to ensure buy in and decision making of the selection team and to help narrow down the selection process to one or two choices. Examples of typical ranking categories are: functionality, total costs, and vendor characteristics. Conduct site visits of practices that use the vendor (if possible), choosing ones that are similar to yours and ask specific questions. Be attentive and watch the flow in the office and how well they use the system. What were the key favored points about the vendor, and what items were least favorable? Select a finalist. It is recommended that you do not notify the other vendors until the negotiation process is complete, in case something becomes unfavorable during contract negotiations, and this will also allow for some leverage during your negotiations. In the event that you do not reach an agreement with the first vendor, you can easily switch to your second choice. Begin contract negotiations and try to include the RFP as part of the contract. Take steps to protect your practice in the event the software business fails, such as putting the software source code in escrow. Consult with a lawyer that is experienced in negotiating with software vendors.

In summary, change is in the air and the more you and the key decision makers in your practice educate yourselves on the qualifications (aka Hoops) for collecting EHR incentives and, most importantly on the daunting process of selecting an EHR vendor the better. There is a lot of information on EHR/EMR out there and one of the best orthopaedic specific articles can be found here on the AAOS website. Make sure you read this second edition AAOS EMR Primer for lots of orthopaedic specific information.

For more information on the EHR incentive program, click here to access the CMS website.

Sources: Todd Kreiger ~ gloStream, Paul Alford ~ Phoenix Ortho, Walt Studard ~ Greenway, Jennifer Kinman ~ Texas Orthopedics, U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, "What's the Best EHR Technology for your Practice?" ~ Mark Newman, EHR Associates

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gloStream

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Phoenix Ortho

"The nation's premier exclusively-orthopedic EHR"
www.phoenixortho.net

What Four Key Tasks to Complete Before You Implement Your EHR
By Paul Alford, EHR Consultant
Phoenix Ortho

So, you've decided to partner with a best-in-class, orthopedic specific EHR provider. You've got the software contract done and the hardware is ordered.  You thought the hard work was vetting the correct EHR partner.  Now all you have to do is "plug it in" and go, right?  Nothing could be further from the truth.  You need to lead your practice through implementation because moving from paperless to electronic touches every aspect of how your office works.

The four key tasks to complete before you implement your EHR are:

1. Empower a champion to lead the project:  The phrase "too many cooks in the kitchen" best describes what happens when more than one physician partner tries to lead the process. In fact, the project champion typically is best to be a lead nurse or office manager with strong leadership skills and a desire to become very close to a robust new software program.

2. Examine and document all of your workflows: Your new software system should be built with the unique orthopedic workflows in mind.  Generic systems built with multispecialty systems in mind often include content that is irrelevant to specialists' work, such as irrelevant codes, templates and more.  In fact, a system without templates, such as the one developed by Paul McCune, Principal of Phoenix Ortho, actually learns each physician's workflows to simplify implementation. However, your office will likely have some information workflows you'll want to improve.

3. Build a relationship with your software implementation team: You have made a hefty investment in your practice and you will want to get all that you can out of your system. So, you should expect the best from your implementation team.  When you choose an EHR built specifically for orthopedic practices, you'll spend less time teaching your team the nuances of orthopedic workflows vs. other specialties.  That being said, your software implementation team cannot do the entire project setup for you, so you'll need to invest time to learn how your software partner can best serve you. Set expectations early and communicate often when you are not comfortable with something.

4. Develop a timeline for implementation that the project champion can meet:  A medical office schedule is at the mercy of patients, surgery facility schedules and more. However, your implementation schedule should be protected at all costs. When the champion cannot get the decision influencers to weigh in, the champion should be allowed to make the call and continue progress. It's easier to alter EHR programming later than to leave the software "on the shelf" waiting for the next meeting. The more quickly and accurately you implement your EHR and have all of your practice physicians humming along on it, the more government incentive targets you'll meet. 

Phoenix Ortho provides the only orthopedic-specific electronic health record (EHR) solution that learns physician preferences, manages workflow and does not require template creation, which can be the most time-consuming aspect of implementation. By deploying orthopedic-specific solutions with Phoenix Ortho, physicians speed through their day easily documenting data, without the hassle of dealing with irrelevant content found in multi-specialty software. Phoenix Ortho is the only EHR solution that uses DICOM, the native language of X-ray and MRI, to place imaging orders. This benefit automatically registers patients at the technician's workstation, reducing the risk of data entry errors or lost files. Within seconds of image capture, the physician can quickly review and interpret images right in Phoenix Ortho, eliminating time waste from going to a PACS viewing station. Phoenix Ortho is the best-in-class solution for all modern orthopedic practices. The time has come.

Don't wait to get started. Check out Phoenix Ortho's orthopedic-specific EHR today and take a step toward an electronic office.  To speak with or request a live demonstration of the nation's best orthopedic-specific EHR software, contact Paul Alford of Phoenix Ortho at 800-843-8179, ext. 116 or palford@phoenixortho.net.

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Click here or on graphic to watch the webinar!

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TOA EHR Survey Results / National EHR Survey Results
 

By Donna Parker
TOA Executive Vice President

TOA EHR Survey Results

TOA sent membership an EHR Survey in September to see where the Association could help educate and simplify the process of replacing or purchasing a new EHR system. If you have not taken the survey, please click here to view and complete.
 
TOA found that most of the doctors responding to the question of their present EHR system: EHR/PM was combined, Meaningful Use Criteria was in place and guaranteed, some EHR vendors would assist in applying for the stimulus funds from ARRA, EHR was at least CCHIT certified, EHR training was lacking – but support was better, orthopaedic specific templates were provided, and the practice was considering upgrading office equipment/hardware. Only half of the TOA members responding were satisfied with their EHR experience to date.
 
More orthopaedic practices are now considering new EHR implementation than already have systems in place. Most orthopaedic practices that are considering utilizing EHR plan purchases in less than two years, have not set a budget, will offer a secure patient portal to patients, would use EHR to participate in clinical studies or research, are interested in upgrading office hardware and in EHR vendors' revenue cycle management offering and have used TOA and AAOS meetings and publications as a resource to search for EHR vendors.
 
The most important items listed in considering EHR were (in order): ease of use, price, functionality, and stimulus funds, with support/training coming in last. However, it is apparent in the responses from the orthopaedic practices having EHR systems already in place that the support and training is very important after EHR installation.
 
Major hurdles in the decision to implement an EHR system were (in order): disruption of workflow, cost, too many vendors to choose from, security/privacy issues, with opposition from within the practice coming in last.
 
One of the our goals with this newsletter and with our educational efforts at TOA meetings is to clear up some confusion about selecting, purchasing software and complementing office hardware when implementing EHR or interfacing EMR with a current practice management system. We are lining up EHR vendors responding to TOA executive staff in our research. TOA feels that responsiveness at this level has given Association staff a chance to participate in webinars, demonstrations, negotiations, and on-site analysis and training. We are certain that the companies spending the time with us will spend the time with you and your clinic staff.
 
If you have not already done so, send the TOA EHR Survey via email to masa@toa.org or by fax 866-864-1568.
 
Thanks go to Irving Orthopedic & Sports Medicine Clinic and to Texas Orthopedic, Sports Medicine & Rehabilitation Clinic for working with TOA staff and letting us in on your EHR experience.

National EHR Survey Results

Much attention in the healthcare IT market has focused on opportunities to expand the use of electronic health record (EHR) systems. According to a Computer Technology Industry Association (CompTIA) study, 34 percent of healthcare providers report using a comprehensive EHR system, while 16 percent say they're using a partial system. The remaining segments are either evaluating their options (29 percent) or have not yet started the process (20 percent).
 
At approximately 17 percent of GDP, the U.S. healthcare market represents one of the largest and fastest growing sectors of the U.S. economy. The administration of this vast system is slowly changing, driven by the need to control costs, improve efficiencies and enhance performance. At the heart of this change stands information technology.
 
According to CompTIA's 2nd Annual Healthcare IT Market: Insights and Opportunities study, more than half of doctors, dentists and other healthcare providers report spending more on IT during 2010 than 2009. The data suggests hardware purchase intent revolves around laptop PCs, tablets, smart phones, servers and data storage/back-up devices. To technology providers or channel partners this should signal an opportunity to help healthcare practices better leverage mobile and information management technologies.
 
Among doctors that have not yet implemented an EHR system at their practice, upfront costs, the disruption to workflow or existing processes, and concerns over usability/complexity top the list of inhibitors. Data security rates as a major concern for 38 percent of doctors, trailing many other factors cited as hurdles. Respondents indicate the EHR capabilities most appealing to their practice include charting, documents storage/management, e-prescription and medications management.
 
We thank CompTIA for sharing their research with us. If you would like the entire study contact Donna Parker via email at donna@toa.org.

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Infonic Document Management

Infonic Document Manager Electronic Document Management system improves your medical practice's business processes by becoming electronic and interfacing with existing EMR and Practice Management applications.

The healthcare industry generates volumes of paper medical, patient, and insurance documents per month. Maintaining paper-based records is labor intensive, prone to errors, difficult to audit and extremely costly. These processes involve the flow of various papers and system generated medical documents that patients are required to submit, such as new patient records, insurance cards, driver's licenses, etc., that must be kept on file.

Healthcare providers are also faced with increased pressures to advance the efficiency of admissions, registration, billing, and records archiving to maximize the overall patient experience. These pressures are also coupled with increased levels of scrutiny due to regulatory compliance issues such as the Health Insurance Portability and Accountability Act (HIPAA). Consequently, it is critical that healthcare providers create a "best practices" approach to manage business information.

Digitizing all health related documents can expedite patient care, improve the quality of care, enhance records management to facilitate regulatory compliance and can yield significant cost savings. If your practice is looking to digitize their paper documents while retaining the current practice management, billing, and EMR systems, etc., then implementing an Infonic Electronic Document Management (EDM) system at your office is the answer.

Electronic Document Management (EDM) systems are commonly deployed to enhance business processes by improving efficiency, usually based on reducing the time taken to perform a certain task. In many cases, the EDM system is not the only business tool being used to achieve the task, but complements existing business applications by providing rapid access to supporting documents or by automation through the use of workflow.

Infonic Document Manager can effortlessly integrate with your existing business applications so that medical practices can ensure a positive and convenient patient experience. This is accomplished by streamlining the paper laden document management process through digitizing patient records and updating an antiquated archiving system. In many cases, the users continue to use the core business systems and the EDM system remains hidden from the users until it is called into play by the integration. Implementing an EDM system will simplify data management allowing focus to remain on core business operations and patient service. Simply press a HotKey from your existing business application (i.e., practice management system) and have near instant access to all the associated paper records in digitized form.

Benefits of Electronic Document Management:

• Improve overall patient care

• On-demand access to vital business and patient data

• Eliminate potential errors

• Increased operational efficiencies

• Eliminate significant paper storage costs, including off-site facility rental and couriers, medical filing cabinets, folders and paper

Infonic Document Manager's solution can be further enhanced with Fujitsu scanners as the document imaging solution front-end capture for paper documents. Fujitsu's technology will also help increase patient satisfaction and reduce operational costs.

Benefits of Fujitsu Scanners:

• Ease of use – simple to install and use, plug and play

• Reliability and low maintenance means uninterrupted business operations

• Image Quality –Fujitsu scanners are supplied with image enhancement software by Kofax to ensure consistently good image quality

• Paper Handling – Fujtisu scanners have excellent paper feeding capability and can manage a mix of paper sizes and thicknesses

• Power Saving modes ensure a low carbon footprint

If you would like to find out more information on how Electronic Document Management system can help your business or receive a white paper on EDM Integration, please contact Kim Kuykendall at kim.kuykendall@infonic.com or (512) 345-4600.
 

About Infonic Document Management

Infonic is a leading provider of business software solutions. The company's highly scalable Infonic Document Manager Suite enhances and accelerates the business processes of small and large organizations including Texas Department of Public Safety (Government), DHL (Logistics), Austin Recovery (Healthcare), U.S.F. Fabrications (Manufacturing), Heard & Smith (Legal), and Investors Savings Bank of New Jersey (Banking).

Infonic's Document Management division is one of the leading global document management system suppliers providing document management software solutions to a wide range of blue chip clients around the globe. Infonic software helps businesses empower their end users through dramatically improving their access to critical business information, reducing their reliance on paper and automating their business workflows, while delivering a rapid return on their investment.

The key benefits of Infonic's document management solution are to:
• Achieve Rapid ROI on existing enterprise software installations
• Significantly improve personal and organizational productivity
• Enhance the speed, accuracy and ease with which people work

Infonic's website can be found here or contact Infonic at us.dmsales@infonic.com.

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Three Days with Irving Orthopedics Clinic – Onsite Data Analysis
 

By Donna Parker
TOA Executive Vice President

Sitting in the conference room of Irving Orthopedics & Sports Medicine (IOSM) taking notes and asking the occasional question, your TOA EVP Donna Parker, is getting quite the education. Kimberly Smith, the Chief Operating Officer of IOSM, has graciously agreed to let me shadow the implementation of their newly purchased EHR so I could report on the agony (if any) and the ecstasy (if any) of the conversion.  Let's just say I was happily surprised at how much I learned about the process of EHR implementation.

Kimberly Smith and Danielle Stedman, PT Department Manager, let me sit in on their In-depth Data Analysis (IDA) of how Irving Orthopedics managed their practice on a day to day basis. With Greenway Medical Technologies EHR solution PrimePractice being used to start the implementation plan, Greenway project leader Sheri Park has asked Kimberly and Danielle to do an internal assessment of the current flow of operations at the Irving Orthopedics.  The goal is to migrate the data of their existing practice management system, GE Centricity, to PrimePractice (first component of PrimeSUITE). Kimberly, Danielle and Sheri hunch over dueling laptops and begin building templates.

Before all patient demographic information from Centricity can be pulled into Greenway's PrimePractice software, basic questions are answered about how patients are checked in and out, how they schedule appointments and verify insurance, and how often they do billing, etc.  All this information will be mapped into the Greenway PrimeSUITE program before the beginning of the year.  The data migration will pull patient schedule appointments from a set date in December from Centricity into PrimePractice.  Irving Orthopedics' IT Consultant, along with Kimberly and Danielle, will oversee a smooth flow of information.

Off-site system administration training will continue with Kimberly, Danielle and a couple of other key clinic personnel, as well as with Drs. Bayless and Westkaemper, two of Irving Orthopedics' doctors who are surprisingly hands-on with the implementation.  The orthopaedists are needed to approve the scheduling templates for the doctors and their physician assistants to make sure the new templates are correctly customized. Kimberly and Danielle plan to schedule the "Go Live" date with Greenway after crucial decisions have been made about which files need to be to archived, selected for migration, and when patient appointments and files need to go paperless.

Interfaces are discussed.  Orders for scanners, printers, desktops as well as new PC tablets are being planned for the main launch in January of 2011.  The current Picture Archive Computer System (PACS) and their super bill scanning system will remain the same for now.  Greenway is addressing all interfaces to EDI clearinghouses, PACS, and has offered to help with the new equipment ordering for compatibility purposes. 

Bit by bit, all the examples of patient charts and doctor schedules fall into the PrimePractice screens.  Sheri Park from Greenway gets a variety of questions after each screen pops up.  Even though Greenway has already made the sell, Sheri is impressing all of us with the cleverness of the new system.  The nuances of each small process are charted, flagged, tweaked and tweaked again to ensure a smooth migration of the data.  Practice management whizzes Kimberly and Danielle are smiling, nodding and sighing with relief after each component is completed.  They have done their homework and it is paying off nicely with what appears to present obvious improvements in the current work flow, better ideas of how it is going to be used efficiently, and the possibility of it all being a smooth and successful implementation.  

Part II of TOA's Special EHR eConnect Series will cover the training of front office staff, all billing department personnel, appointment schedulers, MAs, Surgery Department, DME department and PT Techs of Irving Orthopedics.  The "Go Live" date should be mid-December.  By mid-January, I should be able to give a full report on this EHR implementation.  So far, expectations of ecstasy are within grasp with fewer agonizing moments than I would have suspected in these first three days of a sizeable computer conversion.  Considering the future advantages of a new EHR system and the financial and tax incentives mentioned elsewhere in this newsletter, I am impressed with the possibilities. Tracking of the Irving Orthopedics & Sports Medicine EHR experience will be reported through the first 90 days (meaningful use time frame) all the way to applying for the ARRA stimulus funds.  We invite you to follow us on this journey.

Thanks go to Irving Orthopedics & Sports Medicine and to Texas Orthopedic, Sports Medicine & Rehabilitation Associates for working with TOA staff and letting us in on your EHR experience.

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