There are over 330 electronic medical record software systems for physicians to choose from today.  To complicate the decision process further, in order for physicians to qualify for the financial incentives promised by the HITECH act, “meaningful use” of such a system, (to be defined by the end of 2009,) must be achieved by 2011 for the incentives to be realized to their fullest.  In addition, there is the threat that penalties will be levied  against practices if a compliant system is not implemented by January 2011.

The latest Health IT Policy Council Recommendations to National Coordinator for Defining Meaningful Use Final  
( http://health.state.mn.us/e-health/standards/mufinalrecs102609.pdf ) stipulates that EMRs must maintain problem lists in either ICD-9 or SNOMED.  As of today, the meaningful use definition does not include compliance with the two final rules to continue the transformation of the US healthcare delivery system to an electronic environment through adoption of the next generation of diagnosis and procedure codes and updated standards for electronic exchange of healthcare data announced January 15, 2009 by the U.S. Department of Health and Human Services (HHS).

The first rule adopts the ICD-10 medical data code sets standard for use in exchanging diagnoses and inpatient hospital procedures information replacing and greatly expanding the ICD-9-CM code sets, developed nearly 30 years ago effective 10/1/2013.

The second rule replaces the 4010A1 standards for electronic health care transactions with Version 5010 on 1/1/2012.

The American Medical Informatics Association (AMIA), American Health Information Management Association (AHIMA), and AdvaMed, have issued a summary of their joint position on the adoption of the International Classification of Diseases, tenth revision (ICD-10) which includes the following points:

1. The ICD-9 CM (International Classification of Diseases, ninth revision, clinical modification – a U.S. version of ICD-9 developed by the World Health Organization) is obsolete. Its continued use will adversely impact the value of healthcare data as well as hinder medical decisions based on imprecise data. Further delay adds to the cost of modification and the investment in electronic medical records (EMRs).
2. CD-10 is needed to improve the quality of health information. It is designed to provide better data to meet the needs of today’s electronic healthcare environment and of an increasingly global healthcare system. ICD-10 will enable more accurate and improved information to be captured. ICD-10 will provide better data to support improved public health and bio-terrorism monitoring, more accurate reimbursement rates, patient safety improvement, medical error reduction, quality measurement, and pay-for-performance initiatives.
3. ICD-10 is needed to support interoperable EMRs and a National Health Information Network (NHIN). EMRs and NHIN networks require a modern classification system in order to accurately summarize and report healthcare data. EMR system benefits cannot be achieved fully by utilizing the 30-year-old ICD-9 classification system. ICD-10 must be incorporated into medical software systems with SNOMED-CT in order to realize the benefits of a NHIN and interoperability. SNOMED-CT and ICD-10 will allow data to be shared between EMR systems in their common medical language.

ICD-10 increases the sheer number of diagnostic codes ten fold.  There is not a one-to-one mapping between ICD-9 and ICD-10.  Adding choices and complexity can only help achieve improved health and more accurate payment if the systems and people are capable of codifying data properly.

Doesn’t it make sense to look for an EMR vendor who has a rock solid plan to remediate their EMR solution to utilize ICD-10 codes? To achieve real interoperability and, therefore, meaningful use, you must have a plan in place to train your physicians and staff responsible for coding in the use of ICD-10.  Make ICD-10 part of your criteria for vendor selection and meaningful use.

- Sandra Schafer
President, Turning Point Advisors

About the Author
Sandra Schafer has over twenty five years experience in healthcare IT.  Prior to forming Turning Point Advisors, a healthcare IT vendor consulting firm specializing in product commercialization and strategic marketing, she was Senior Vice President of Marketing and Product Direction at CareMedic, Vice President of Marketing and Product Marketing at NDCHealth, Vice President of Strategic Business Development at Healthcare.com.  Sandra began her career at HBOC, now McKesson where she spent 17 years in various management positions.  Ms. Schafer holds a B.A. degree in Business Administration and a Masters in Healthcare Administration from the University of Iowa.

The decision to implement an electronic health record (EHR) is one of the most important decisions for your health care organization or physician practice. The transition to an EHR system changes everything. Nearly every business process is impacted with the EHR implementation from registration/admission, scheduling, documentation, billing, patient follow-up, and communication within and external to your organization. Considering the profound change this implementation generates, your organization needs a clear road map to ensure a successful transition that will capitalize on the quality, safety, financial, and process benefits of the implementation.

Getting It Done Right

Successful and effective implementation requires hard work, careful planning, and diligence. In 20 years of implementing EMR and clinical information systems, we see patterns in the successful deployments. There are key elements to successful implementation from adoption approach, change management, process redesign, testing of the application, hardware, and interfaces. This article focuses on one area crucial to success, project planning.

Project Planning – What Should You Do?

Best practice in management of an EMR implementation has a vendor project manager with broad knowledge of the EMR application working with a project manager (PM) from your organization to develop a comprehensive project charter, project plan, and communications plan. Both PMs should have experience with multi-department implementations. If the PM skill is not available in your organization, often, a third-party consultant project manager is hired to plan and manage the effort. When leveraging a consultant always identify an internal leader in your organization that will be mentored through out the implementation.

At the end of the EMR project, someone in your organization will need to own the support and management of the application. A consultant project manager that mentors an internal resource puts your organization on track for success. Too often, we see organizations struggle after an implementation because much of the knowledge walks out the door with the vendor team and the consultant.

What Can Happen to Your EMR Project?

So what happens in this scenario? Your organization does not have a clear understanding of the scope of effort, complete project plan or a clear implementation roadmap. You do not understand the logical order of tasks, how your organization can most effectively prepare.

The various vendor implementation specialists connect with identified key contacts in your organization and these resources follow their plan or task list to complete configuration of functional areas. You can have multiple application specialists asking for information from many areas of the organization to complete master file and table builds. The vendor usually has an engagement manager (EM) who is overseeing your implementation. The vendor EM manages the overall effort of the various application specialists and can be the one-team member who understands the big picture surrounding the implementation. Often the individual vendor team members do not have a broad understanding of the overall EMR application or understand other functional application areas. There tend to be few team members knowledgeable about the whole application and implementation process.

You begin to wonder how the various decisions made for configuration work together. How do the decisions affect workflows? Is the vendor defining and documenting future state workflows with clinical areas? Often little attention is paid to this critical area of EMR implementation. You can be left wondering if the infrastructure, interfaces, and hardware needed will be ready at the right time. If you have an internal leader for your EMR project, they can struggle to comprehend and manage all of the moving parts of the project without a clear and complete plan and the right tools to manage the project. A well-defined project charter, project plan, and communications strategy are the best way to know your EMR initiative is on time, on budget, and being implemented using best practices.

Take Charge and Do It Right!

Documentation of a project charter defines the project. It documents the what, how, who, when, where, and why of the project. The project charter articulates scope, approach, and clearly defines measures of success that help to manage expectations for the initiative. Project risks are defined, analyzed and mitigation strategies developed and implemented. Typical EHR project risks are expectation, resource, acceptance, solution, and impact.

Communication planning is a critical component to the success of large projects. It involves determining what information needs to be communicated to whom, when, and how. The types and frequency of communication will vary depending on the audience, as different groups of people have differing levels of need or want to be informed. Understanding the needs of all project stakeholders and effectively communicating pertinent data is one of the keys to a project accomplishing its goals.

Communication techniques and technology will also differ based on the type of information. There will be formal documents that outline policies, requirements, and processes. There will also be informal communication via e-mail, phone, and meetings. Designing an organized approach to manage all these differences will enhance the team’s ability to make decisions, share data, educate, influence, and resolve issues.

The communications plan defines the various meetings, communications, reports and documents used over the course of the project. It is important to be clear about the intent or intended yield of the various forms of communication. Will the communication inform, educated, or influence the reader? For example, when you provide communication to a particular audience, is the communication meant to be one-way or two-way? Are you looking to inform the audience or do you want feedback? Is action optional or required by the reader? The plan should coincide with change management strategy. An effective communications plan can help to establish expectations and increase acceptance for the project and new software tools being implemented.

Project planning should be done using industry standard project management software such as MS Project, thereby leveraging many timesaving features for planning, tracking, and reporting project status. The project plan must document all of the project tasks: tasks for the vendor team, provider team, and other vendors involved in the project. The plan should encompass the entire project life cycle, from kickoff to transition of support services, and identify critical project milestones. The project plan identifies key dependencies among the various tasks. The plan is analyzed to identify risks and mitigation strategies developed. Tasks and responsibilities need to be defined within the project plan to review and manage the quality of deliverables for various project areas.

Clearly defined project governance is critical to the success of an EHR implementation and a well-managed project. A RACI diagram is well suited to identify the various project functions, roles, and responsibilities. The diagram documents who is responsible, accountable, consulted, and informed (RACI) for decision making and getting the work of the project completed in various areas. A project organizational chart clarifies who is in what role and articulates reporting responsibilities. Numerous decisions are made over the course of an EMR project, a well thought, and communicated governance structure facilitates this process. Review of successful EHR implementations point to complete and rigorous project planning as a crucial area to ensure successful implementation of your EHR. Further, building knowledge, skills, and ability in your internal resources is vital for ongoing user support and system maintenance after the implementation is complete.

About the Author
Janice Ahlstrom, CPHIMS, RN, BSN, is a partner in Wipfli’s health care practice. She has over 28 years of experience in the health care selecting, implementing and integrating enterprise information systems. She has helped a variety of organizations develop technology strategies, implement EMR applications, define business processes, enact operational performance improvements, and implement information systems. Contact Janice at 414.431.9352 or email her at jahlstrom@wipfli.com.

About Wipfli LLP

With more than 800 associates and 15 offices across the Midwest, Wipfli ranks among the largest accounting and business consulting firms in the nation. Serving businesses and individuals since the firm’s start in 1930, Wipfli has one of the region’s strongest healthcare practices, with an extensive list of clients across the Midwest.

For more information, visit www.wipfli.com.

Here are some important considerations regarding ease of use, security, and other factors when comparing medical billing software options:

1. When you start using the medical billing software, moving from one screen or one function to another should be intuitive and make sense to you, the user.  Do transitions from screen to screen proceed logically?
2. Is there a simple graphical interface between different modules of the medical billing software?
3. What about data security and HIPAA compliance?  Is it easy to make backups of your software? Can you password-protect sensitive data from unwanted users?
4. Can the medical billing software track insurance policies and data?
5. Are there customizable templates for standard functions within the medical billing software modules?
6. Can several staff members access the medical billing software program simultaneously?
7. Is there a web-based component to your system, so that users can have  password-protected access to your  system from different locations?
8. Are the templates easy to customize for a specialty practice?  For instance, if yours is a cardiology practice, you will need different types of templates than a dermatology practice: hypertension templates, cardiac cath templates, etc.
9. How easy is it to import data from outside sources, such as HHS and other government agency sites?
10. How easy is it to fill out standard forms?  Are HCFA forms easy to fill out?  What about easy access and analysis of CPT and CDT codes ?
11. Are interfaces with external sources easy to set up from within the billing and scheduling system?
12. How difficult will it be to import data from simple software sources, like Microsoft access spreadsheets (with xls extensions)?
13. How difficult will it be to import data from paper sources?  Is there any OCR facility available for scanned data?
14. Data conversion: how difficult will it be to convert data that is already on some other medical practice or medical billing system (perhaps one that you practice has outgrown)?
15. Does the software allow for multimedia attachments, such as pictures, scanned documents, x-rays, and even voicemails and files?
16. Does the software have a “free-trial” option so that you are not locked in to the system before you have seriously tried it out?
17. What are the training options that come with the software you are considering?  Is there a human tech-support contract option that comes with the software, or is training available only online?  Is there a person that is assigned to your company to provide tech-support?  How expensive is it to buy additional tech support time for you and your staff?

No one likes to think about everything that can go wrong, but you do need to do serious planning so that things will go smoothly with your medical software implementation.  Invest the time in comparing systems up front, so that you will eventually choose a medical billing system to fit the needs of your practice.

If you are a smaller practice or a solo practitioner, one of the most daunting aspects of buying and implementing EMR is the price: purchasing, licensing, implementation, and training can cost a true fortune. This outlay can make sense and save money for a large medical organization. If the system is implemented carefully, it will cut the number of man hours you need, perhaps reduce the number of employees, and help your practice comply with government reporting requirements.

However, if you are a solo-practice, or part of a small practice, this financial investment would be overwhelming. But you certainly need to make headway into the world of EMR and medical billing software, if you haven’t already. Is this feasible at a modest price?

The answer is, very feasible indeed, depending on how you make your choices.
There are two basic types of EMR software configurations available: Each software model has its upside and downside.

1. Client/server based software is housed and maintained on your own server.
Most of the large, well known EMR software packages are client/server based. This means that you and the developer – whether you buy the package customized, or whether you provide customization in-house — totally control the environment and can be tailor exactly to your needs. Most of the specialized practice packages are client/server based. Many client/server EMR models are web-enabled, meaning users can connect to their EMR via the internet on a standard web browser from a remote location – but the software will still reside in-house. Web-enabled software packages sometimes offer the option of handling security issues “elsewhere” by offloading the maintenance issues to a third-party host .

If you are not concerned about Stimulus payments, and whether the US government views you as making “meaningful use” of your EMR software, there are inexpensive client/server based options available at more reasonable prices. While these are not the CCHIT certified packages, they may be able to serve your basic EMR needs very well. There is even “open source” EMR software available free of charge, but it will require customization. If you are willing to go with a basic EMR / medical billing software package which performs basic functions reasonably well, and if you are willing to dedicate resources to customization and maintaining system and data security, open source software may work for you.

If you go with an off-brand EMR package, there is training and customer service available. If you decide to go with “open source” software, there is no customer-training or customer service division to call when you are desperate for help. You have to make your own security and backup arrangements, and there is no one to reassure you when there are data problems. If you are technically savvy, you may be able to make these arrangements yourself, but talk to others who have used this software before committing yourself to it!

2. Software as a Service (SAAS) EMR, offers a web-based model.
SAAS software does not live on your computer or server, but in cyberspace. For SAAS EMR software, you the user log onto a website from any internet-accessible computer hosted by a software provider to whom you pay periodic fees.

SAAS EMR can be accessed from anywhere. You do not need a dedicated IT person taking care of your computers, because security, back-ups, and updates are taken care of by the hosting company. Your up-front costs are usually much smaller than they would be for a client/server model since you don’t have to worry about hardware or network infrastructure. Your up-front costs are usually much smaller than they would be for a client/server model since you don’t have to worry about hardware or network infrastructure.

The disadvantages of SAAS EMR are that it may be difficult to configure specifically for your practice – sort of like buying suits off the rack instead of bespoke tailoring. Web-hosted software does not currently afford exact customer-tailored customization, although that will likely change.

Another possible problem: the smaller up-front costs may be deceptive. A host or vendor of SAAS can always up the rates. You don’t own any more of the systems two years into using it than you did on Day One, so you are basically a “renter “and the tax advantages and deductions afforded by a major corporate purchase are not there for you.

In summary, just because you are small does not mean that you cannot have excellent and extremely useful EMR software. But look carefully before you leap.

1. Medical notes and correspondence are the face and the front desk of the medical practice to patients, other doctors, insurance companies, and government agencies overseeing Medicare and Medicaid. A poor and inaccurate job on notes and correspondence will mean slow turnaround in claims processing as well. The inability to quickly access patient notes will also cut into a practice’s ability to counter claims denials. Sometimes an insurance company will audit a doctor’s  claims and call his decisions into questions. Medical transcription software linked to a good EMR can save the day in such situations.
2. Medical practice management software / EMRs can shave a salary – or half a salary — off your expenses by automating your transcription.  If you have an in-house person spending much of his time on your notes, good medical software will free him to work on other practice management functions.
3. In addition, paper correspondence calls for lots of square footage to house those charts and letters.  Renting space is expensive, and not needing to pay for the extra storage space can be a significant savings as well.

Many EMR packages contain excellent medical transcription software, or allow interoperability with well- known medical transcription packages.  If you already have good transcription software and do not want to lose it when you purchase an EMR, talk to the EMR vendors about interoperability. If the medical transcription software and / or medical billing software you are using are supported by reputable vendors, there is a good chance it can be integrated with your new EMR system.

Here are some valuable features to look for in medical transcription software:

• Speech and voice and speech recognition software has been used for medical transcription for many years.   This can save literally hundreds of hours of work per year for a doctors office.  After a little practice, turnaround time for medical dictation is almost instantaneous.
• Good medical transcription software usually comes with a medical dictionary and spell checker,  to save time for accuracy checks
• Many software utilities that come with medical transcription software are HIPAA compliant, and are thus suitable for using to send files to other computers and to insurance companies.
• Electronic signature software allows for signatures and audit trails for those signatures. Pulling files for signatures becomes a trivial matter with signature software and electronic notes to post them on.
• Time and date stamps for notes and letters make for good audit trails, reporting, and HIPAA compliance.
• Management reports to handles the status of medical correspondence. Monthly reports, status of dictated files, etc.
• HIPAA compliance for notes, which means encryption features and backup and security procedures are in place.
• Interoperability with handheld electronic devices such as PDAs, as well as laptops and notebooks
• Electronic attachment of transcribed reports to a patient’s Health Record
• Searchability of all documents: letters, notes, and prescription records
• Predefined templates for letters, prescriptions, and other correspondence make for major time saving

If you are about to buy medical software, make sure you invest in an EMR that has good transcription software or supports the use of good transcription packages.  Read the reviews, talk to other users, and have a vendor demonstrate the software along with a prepared list of questions to ask. And be sure to try it yourself before you buy. Good medical transcription software can make a real difference in the bottom line for your practice.

Large Practice
If you run a large medical practice or health-related organization, you probably have to meet many regulatory rules, provide scheduling at multiple locations and manage different coding requirements for Medicare.  In that case you should be evaluate a medical practice management software that covers both an electronic medical records or EMR and medical billing.

A good medical software package that handles all of these function – can be used to full advantage by a well trained staff, and  can improve your bottom line.

Small Practice
But what about a small medical practice  — how much medical software do you really need?  The answer may be – at least for the short term – very little.  What a small practice really needs is medical billing software – and a good stand-alone package will do. Here is why:

• If your practice is small, you do not need all the bells and whistles of medical practice management software, but you do need the medical billing function. Full-featured medical practice management software may have many more features than you need, and can use effectively. There’s a risk that you’ll pay too much and it’ll be underutilized.
• Performing in-house medical practice billing without decent software can cripple the medical billing process for your practice. Since denial of claims by insurance companies, Medicare, and other health care payers are common.  It’s critical that you have the ability to submit and update claims electronically and check for viable codes.  Without it, you can create an unending traffic jam in your bill processing which can affect your cash flow.
• Unless you outsource to an inexpensive medical billing service, you’ll pay top dollar – and middleman service charges – for something that a small scale medical billing software package can do for you very efficiently.  As a category, Medical billing software is now a pretty mature product.

Do proper due diligence when purchasing a stand-alone medical billing software package.  Most good medical billing software have easy-to-use interfaces and upgrade paths to fully featured EMR software and medical practice management software.

Consider a web-based medical billing software rather than client/server.  As a small practice, it’s much easier to have someone else worry about data security and backups.  Plus you won’t have to make the up-front investment in buying the hardware and the software.

Sometimes, the choice of which EMR system to use is less important than the “change management” and training plan an organization chooses.

Implementing even the best-designed medical practice management software changes the manner of doing business significantly for a medical practice. It can entail a fairly steep learning curve.

Here are some critical training issues to keep in mind:

1. Make sure that everyone who will use the system gets adequate training.  Good training – or lack thereof – can affect the success of the EMR software within your organization. Both clinical and administrative staffs need to be trained to use the same modules since they will need to exchange relevant information.  If the software is underutilized, it can wind up costing you time and money.
2. Try to get everyone on board and positive about your new EMR software.  If key members are grumbling and not committing to learning their parts of the system, the implementation might not go smoothly. Make it fun.
3. Assess everyone’s general computer skills (the younger employees are probably more able than the older employees – even though they are less sophisticated professionally).  If needed, get training to bring everyone up to basic computer skills level – everyone should be comfortable with use of the mouse, basic graphic interface, hierarchical file structures, password use, etc..
4. Develop your training plan to as part of your overall implementation plan. The plan will have to be driven in part by the skills of the staff.  Appreciate that even the most brilliant and senior physicians may need significant ramp-up time to use the system well. Don’t overwhelm users with too much change and detail too soon.
5. Implementation in phases – rather than overnight – is a preferable so employees can learn at their own pace and feel confident about the software. A functional modular approach to training allows change to happen more gradually.  For instance, you may choose to train and implement a medical billing system first before the full EMR is introduced.
6. Practice makes perfect. After training, dedicate time to letting staff practice what they’ve learned.  If you hire an outside company to train, have them on-site post training to answer staff questions and work through problems.

In short, take the long-term view:  if you view your EMR training time as part of your medical practice management software investment, and you plan your training to fit the needs of your particular staff, your migration to EMR is likely to succeed.

If your practice has yet to invest in Medical Practice Management Software or Medical Billing software, you can get still get top of the line e-Prescription (electronic prescription) software for free by signing up with the NEPSI.  The National ePrescribing Patient Safety Initiative is dedicated to helping prevent medical errors caused by prescription errors. The software is based on ePrescribe from Allscripts ™, and is available to physicians for free by Allscripts and the other NEPSI sponsors.

Allscripts e-Prescription software does not have to be used in conjunction with other medical practice software.  It is a stand-alone web-based product.  It is encrypted and contains other safety and security precautions, and thus protects the privacy of doctors, and their patients’ data.  Allscripts ePrescribe™ provides a complete medication database to users, along with clinical decision support and reference material.

Benefits of e-Prescription Software

1. Handwriting mistakes are avoided
2. All prescriptions are checked for drug interactions, allergies, dosing errors, pregnancy related issues, and other related problems
3. Electronic medical record is created based on the patient drug information
4. Comprehensive drug database is maintained and kept up-to-date
5. Prescription refills are easy and fast
6. Communication is improved between doctors and pharmacists
7. Helps doctors and their patients to identify less expensive medication options
8. Provides up-to-date drug coverage insurance information

Allscripts, the medical software company, Dell computers, Microsoft Corp, Sprint Nextel Corp, and SureScripts ™ and a host of other corporate health, medical, and communications-related companies sponsor this initiative across the United States. Allscripts and the other sponsoring vendors do not make money on this offer. They are engendering good will and hopeful that some physicians will try their medical practice software products down the road.  An Allscripts customer service team provides training and support for the product’s use. The Allscripts software is also designed to be interoperable with other vendors’ e-health records software.

You must be a physician in order to register.  Only one physician per practice can register for the program (although more practice members can register later).  Physicians can register on line for this e-prescriptions program at:

https://erxnowregistration.allscripts.com/

CCHIT was founded and funded by industry associations, and by seed money from HHS. In addition, many large vendors themselves are helping to fund CCHIT.

Many software buyers are using CCHIT verification to decide which software to buy. However, there may be many credible vendors that are not spending the money on CCHIT certification, and still maintain the standards that CCHIT certification sets.

Then, too, setting a standard for specs on an EHR system does not mean that a system delivers a quality product or produces credible results as a result of that spec. CCHIT certifies the presence of a function within the EMR software or EMR software.  But it does not say anything about the success of that function from a usability or patient perspective.

Larger vendors are able to offer various types of stimulus packages and discounts to promote the use of their EHR software.  For instance, GE is now offering no-interest loans to doctors who want to purchase their EHR product, the Centricity EHR system. GE has just announced that Centricity has received CCIT Certification.   Will CCHIT certification become a kind of licensing that is necessary to sell medical practice management software?

The medical software industry is a young industry within the IT field.  The value of its new efforts at self-regulation through CCHIT and government oversight and incentives coupled with stimulus benefits have yet to be measured.

In February 2009, the American Recovery & Reinvestment Act was signed into law.  The HiTech Act is the health IT component of that bill. It provides significant dollar incentives for physicians to move from paper-based medical information tracking to computerized Electronic Health Records, that medical practice management software and patient information management systems.

If you are a physician contemplating this major change, you can appreciate how much EHR system will change how your day is structured, and the costs associated with such making this change.  You and your staff will have to  transition from your current method of storing data to the electronic medical records (or, as the government would prefer to call it “health records” system). You will have to train yourself and your staff to use this new system. You may well have to pay outside consultants to help you implement such a system.

The HiTech Act allocates $36 billion for incentive payments to healthcare providers who demonstrate use of Electronic Health Records (EHR). There are two allocation programs, one for physicians who have many Medicaid patients, and a second program for those who accept Medicare.

Medicaid providers: Doctors in practices where 30% percent of their patients pay via Medicaid, are eligible for a payment of $64,000 over five years. (for pediatricians, the required percentage of Medicaid patients is only 20%)

Medicare providers: Doctors who accept Medicare patients (even if they do not accept Medicaid) can receive payment of up to $44,000 over five years.

In addition, doctors who make use of ePrescribing initiatives that are part of the Medicare Improvements for Patients and Providers Act of 2008 and PQRI incentives, can earn between $6,000 and $8,000 without moving over to the Electronic Health Records System.

In order to qualify for the Stimulus incentive payments, doctors have to demonstrate three things:

• Purchase /use of a “certified” EHR product (meeting HHS standards) that has an ePrescription capability
• Connected access to a patient’s full health history via electronic connectivity to other health providers
• The ability to report on the providers technology use to HHS

There are also incentives to implement EHR very quickly. Incentives include payment for up to 5 years, but the bulk of the payments come in the first years,  In addition, physicians receiving payments must demonstrate that they are making use of the medicare component of the EHR.  If a physician accepts payments, but does not demonstrate use of the system, penalties can be assessed.

If you as a physician have been contemplating the move to an all –software medical practice management system, perhaps the time is now.  Healthcare legislation will be pushing your practice in the direction of EMR and EHS.  Investigate and compare certified EHR and EMR software now, and see what medical software makes sense for you.