Oleen Pinnacle - Healthcare Management Consulting

There is little question that the EHR will become a requirement for physicians in the not too distant future. Now may be the calm before the storm and an excellent time to prepare. When it comes to an EHR, the old adage "those who fail to plan, plan to fail" could not be more true.

There are many factors that come into play when considering an EHR and physicians should anticipate a substantial assessment and planning process before evaluating products. Creating a unique practice profile will involve addressing issues such as specialty specific requirements, current I.T. infrastructure, and existing practice management system, documentation styles of providers, deployment and financial considerations. The likelihood of succeeding with an EHR will be greatly enhanced by developing a plan before ever speaking with a vendor.

Oleen Pinnacle has over twenty years of experience working with medical practices and healthcare technology. We provide medical practices with an array of services to help them make the EHR transformation from paper to an electronic patient record. We have developed our own methodologies to assess a medical organization and bring to light areas that must be considered in the product selection process. We can support a practice throughout the entire process, from pre-implementation planning (Readiness Assessment) through to post implementation support.

Practice Readiness Assessment

The first steps in bringing an EHR into a practice should take place before staff members even speak with a vendor. Understanding the special needs of an organization, setting realistic goals and expectations, as well as attaining buy-in from stakeholders are critical to success. Specialty specific requirements, workflow and documentation preferences, and practice management system issues are just some of the areas evaluated in a Readiness Assessment engagement. When completed, the product selection and system implementation that follows will be greatly enhanced. Our consultants will set clear goals and expectations for the practice and will prepare it for the EHR transformation process.

System Requirements & Selection

Transferring a practice's requirements into a request for proposal (RFP) and setting the parameters to engage with vendors is the next step in the process. Additional factors such as interface specifications, RHIO/HIE requirements, acquisition costs, and vendor stability evaluation are assessed and reflected in the RFP. We will develop a profile of requirements and manage the system selection process through completion to ensure the selection of the right system for a practice.

Contract Negotiation

Having a knowledgeable EHR professional working with the practice's attorney is essential to safeguarding its interests. We will ensure that the important business issues are addressed in vendor agreements and the practice's investment is protected.

Implementation Management

Our consultants will establish a comprehensive project plan that will reflect input from the staff members of the practice as well as vendor representatives. It will entail time frames for meeting critical milestones and will include regular status updates. With years of experience coordinating activities among I.T. vendors and practice administrative and clinical staff, we will ensure that the practice experiences a smooth and successful EMR implementation.

Post Implementation Support

Typically, the first few months after go-live is a time when fine tuning will need to take place. Issues related to workflow and process change will always emerge. If these go unattended, they could lead to a mini crisis or worse. Having a guide available to smooth out these rough spots can make all the difference.

FOR MORE INFORMATION CALL (315) 446-1612 and ask to speak with an EHR Consultant or contact John Netti at jnetti@oleen.com



Physician Incentives Under The American Recovery & Reinvestment Act of 2009 (ARRA) The physician incentives included in the American Recovery and Reinvestment Act of 2009 (ARRA) have been made public but the details will not be published until sometime before the end of the year. ARRA allocates $19 billion in incentives to be distributed through Medicare and Medicaid for independent physicians demonstrating “meaningful use” of an EHR system. Meaningful Use: “Meaningful use” involves a physician using a “certified” EHR with e-prescribing, “connected” for the electronic exchange of health information, and submitting clinical quality measures. Certified EHRs: The current status of “certification” has a few dimensions. First, although the Certification Commission for Healthcare Information Technology (CCHIT) has been the designated certification organization under President Bush, the Obama administration has not identified it as such for the ARRA incentive programs. This has created some uncertainty about what a certified EHR will be, although all bets are that CCHIT will remain the certifying body. Also, some states such as New York have developed EHR functional requirements that exceed those of CCHIT. In time these may become the de facto standards required to connect to a State’s health information exchange. A practice should consider state requirements when selecting an EHR system. Medicare Incentive: The Medicare portion of ARRA payments for meaningful EHR use will be made over a five year period beginning in 2011 and ending in 2016. Physicians can earn up to a maximum of $44,000 over this period. First year payments can be as much as $18,000 if adoption is achieved in 2011 or 2012. Physicians that wait until 2013 will begin to lose a portion of the available incentive for each year they do not adopt. No incentive payments will be made beyond 2016. Payments will entail 75% of allowable charges for professional services. AARA also outlines penalties. If an eligible physician fails to demonstrate meaningful use by the year 2015, their Medicare payments for professional services will be reduced by 1%. The reduction will increase to 2% in 2016, and 3% in 2017. Additional reimbursement reductions of up to 5% for subsequent years have been authorized if the proportion of eligible physicians who are meaningful users nationally is less than 75%. Medicaid Inventive: To qualify for the Medicaid program, a provider’s patient base must be at least 30% Medicaid (20% for pediatricians). The incentive focuses on adoption, implementation, upgrades, maintenance, and operation of a certified EHR. It extends over a five year period. It can reimburse up to $25,000 per physician for system purchase, installation, and training. There is also a potential for $10,000 per year for maintenance and operation for each of the remaining four years. The total possible incentive for Medicaid is $65,000 per physician. Unlike Medicare, there is no mention of a disincentive for non-adoption. Also, you cannot participate in both the Medicare and Medicaid programs