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How much will ICD-10 implementation really cost?

Converting to ICD-10 is the largest healthcare mandate in U.S. history, and it comes at a price. Early estimates suggest small physician practices could pay $83,290 for the transition. But, as reported in EHR Intelligence, a recent study in the Journal of AHIMA paints a more hopeful picture. Based on new data about available solutions, authors estimate the cost for a typical small physician practice to be somewhere between $1,960 and $5,900. So, depending on who you talk to, it can cost anywhere from $1,950 to $83,290. Anyone involved with ICD-10 implementations understands it’s the project’s complexity that makes it difficult to estimate cost. Where are the biggest discrepancies? There are a few areas in which these studies differ: 1. Training Researchers who expect lower costs maintain that there are more ICD-10 training options available to clinicians today, including more [...]

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An ACO rookie’s most common mistake

To stay competitive in an evolving healthcare landscape, independent small physician practices are creating their own Accountable Care Organizations (ACO). It’s important for them to have accurate expectations before applying to Center for Medicare & Medicaid Services (CMS) and its Shared Savings Program. Unfortunately, new ACO applicants often miscalculate the number of CMS patients, or “attributed lives,” they are responsible for, putting their entire cost structure at risk. Whose patient is it? CMS assigns each patient to a provider who will be responsible for that patient’s cost and quality of care. A sophisticated algorithm determines where this patient belongs, based on claims data. A smaller primary practice may assume that every History and Physical (H&P) it performs for Medicare patients will count toward its attributed lives total, when in fact that is not the case. For example, if that patient [...]

“There’s an app for that” is a common expression proving true in healthcare IT. For example, SAMA HealthCare Services (El Dorado, Arkansas, U.S.A.) uses third-party applications to customize its electronic health record (EHR) core and improve patient-centered care. It launched eDoc4U in May 2014 to automate required annual Medicare wellness exams and assess health risks. In a recent case study, SAMA HealthCare lead physician Gary Bevill said, “We’ve pushed the envelope and look for ways to keep the patient foremost in the encounter…With Allscripts Professional EHR and eDoc4U, it was a way to further extend that goal and offer much greater value to our patients.” The big picture: Improving care in Arkansas According to the United Health Foundation, Arkansas is the second unhealthiest state in the nation, with high rates of smoking, obesity, diabetes and poverty. Lack of preventive care, [...]

Many providers are finishing up their 2014 attestation period for Meaningful Use, the Centers for Medicare and Medicaid (CMS) incentive program for successful use of electronic health record (EHR) technology. Several changes in the regulations in 2014 have prompted questions. Using information available today, I’ve answered some of the most frequently-asked questions here: Q. Do we need to attest several times throughout 2015, or do we attest only one time after the end of 2015? As of today, if you’ve attested for Meaningful Use before, you only need to attest once. You will demonstrate for all of 2015 and attest before February 29, 2016.  (Exception: people who have never demonstrated before will have a 90-day demonstration period.) However, on January 29, 2015, the Chief Medical Officer of CMS issued a significant communication about some possible future adjustments to the Meaningful [...]

Patient engagement is essential to improving care, but it can be a tough climb. For example, U.S. clients often note the most challenging government incentive measures are the ones that require patient response. Health First (Brevard County, Florida, U.S.A.) recognized the importance of genuine patient engagement, including millions of dollars in potential Meaningful Use incentives. Below, Health First shares how – within just a few short weeks – it achieved 52.6% of patients with online access and encouraged 6.8% of patients to view information electronically. Here are some of the successful strategies from Health First Vice President of Enterprise Applications/Informatics and Chief Nursing Informatics Officer Karie Ryan, RN, MS, BSN: 1. Remember that implementation is just a first step. During the summer of 2014, Health First implemented Allscripts FollowMyHealth® patient portal (and rebranded it HFConnect). But just building a portal [...]

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Finding tomorrow’s high-risk patients

As the healthcare industry offers more ways to earn risk-based or value-based revenue, providers are more proactively coordinating care, engaging patients and managing population health. Analytics are fundamental to all of these strategies, even in small practices. To be successful, physician practices need analytics that are predictive across multiple populations. They need to know who the high-risk patients are today, but they also need to identify the “rising-risk” patients. With intervention, these patients can have a healthier future. The cost of unmanaged cardiac conditions One healthcare organization evaluated its Accountable Care Organization (ACO) population with Johns Hopkins Adjusted Clinical Groups (ACG®), an industry standard to adjust risk and predict future healthcare usage. With analytics, this ACO found that more than half of its patients were either high risk (30%) or very high risk (27%). Furthermore, it found that the average [...]

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3 ways to build a better hospital budget

Featured in a new success story, Kaleida Health (Buffalo, New York, USA) recently used Allscripts EPSiTM to save more than $20 million in one year – while still maintaining a high quality of care. The organization, one of the largest in Western New York, needed to reduce overall spending to remain competitive. Kaleida Health turned to EPSi, which provides clients integrated budgeting, financial decision support and long-range financial planning, helping to improve patient outcomes while reducing costs and maximizing revenues. Kaleida Health used three methods to identify total cost opportunities throughout the organization: 1)      Break up the budget process. The team at Kaleida Health examined each service line individually, determining the utilization and per-patient cost targets. “Breaking it into smaller pieces made it more actionable,” said Kaleida Health Senior Director of Decision Support Christine Lanza. 2)      Develop a strategic approach. [...]

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Big time data analytics in a small town

Search for examples on data analytics in health care, and you’re likely to find lots of stories featuring large integrated health systems in urban areas. But don’t overlook what’s happening in rural communities such as Hutchinson, Kansas. It’s the focus of a recent Healthcare Informatics article, Innovation on the Plains: Hutchinson Clinic’s Bold Data Moves. Hutchinson Clinic CIO, Bob Davidson, points out that though the clinic is based in a small town (population: 45,000), more than 262,000 patients from across the state actively rely on the organization for care. With Allscripts TouchWorks® EHR as its core solution, Davidson shares advice on the value of data, including these insightful quotes from the article: Value of coordinated care “Our doctors have to do their own rounds with the hospital across the street, and take turns covering their call, and so on. And [...]

Editor’s Note 1/28/15: Ovum recently featured this client in a publication, “Best-Practice Electronic Patient Record Deployment at Salford Royal NHS Foundation Trust.” Download it here. When Salford Royal NHS Foundation Trust, located in Salford, United Kingdom, received funding to go semi-mobile in its wards, the organization partnered with Allscripts to help bring the project to life. The effort required a very rapid development timeline, with the project beginning and launching in less than 9 months. Salford Royal has been using an EPR for more than 10 years, and implemented Sunrise™ Acute Care (formerly known as Sunrise Clinical Manager) in June of 2013, so clinicians were familiar with the multitude of benefits that come with going paperless. But Salford Royal needed a flexible, cutting-edge system it could tailor to meet the needs of its patients and clinicians, helping reach the organization’s [...]

Small, independent physician practices have the best of healthcare IT worlds, and the worst. On the plus side, they can control everything that happens inside their walls. They have access to their clinical and financial data. They can be more nimble with Healthcare IT decisions than larger organizations, from selection to implementation to governance. But if small practices don’t have analytics, they could be losing money. And they may not even realize it. Most practices don’t have the right tools Small practices likely have reporting tools in their electronic health record (EHR) and practice management solutions. “Canned” reports can help track and monitor certain aspects of a practice, which is essential to having a healthy core. But it takes more sophisticated analytics tools to really understand things like referral patterns, clinical pathways, care coordination – especially in context with cost [...]