Hielix EHR Blog

Benefits of the ICD-10 Transition

gdavie@hielix.com (Gavin Davie) — Thu, 08 Dec 2011 17:00:10 +0000

The transition from ICD-9 codes to ICD-10 is long overdue. We have essentially run out of codes and unfortunately the timing could not be worse for physicians, hospitals and the healthcare industry overall. There is no good time to take this project on. It will be expensive, it will be tedious and it will not happen overnight.

In 1993 the World Health Organization (WHO) implemented the ICD-10 diagnostic code set to replace the ICD-9 code set, which was developed by WHO in the 1970s. ICD-10 is utilized in almost every country in the world except the United States. This code set is not simply an increased and renumbered ICD-9 code set, it comprises greater detail, changes in terminology, expanded concepts for injuries, and other related factors. The complexity of ICD-10 provides many benefits because of the increased level of detail conveyed in the codes.

When the dust settles, the benefits from implementing the ICD-10 code set will be noted. We can expect a decrease in claims returned for “insufficient documentation.” Historically, approximately 20% of all claims are returned to the provider due to lack of documentation to support the diagnosis or procedure code. The increase in granularity the ICD-10 codes provide should contribute to a decrease in administrative costs that are currently incurred using the ICD-9 code set. There should be an increase in auto-adjudication processes and a decrease in the need for the constant manual review, which currently delays reimbursement at a minimum of 60 days.

The new code set will clearly provide a better identification tool for patient population, demographics, and the tracking of disease in greater detail. Improved tracking of disease will improve case management and enhance the opportunity to involve patients in wellness programs. The global sharing of best practice information will also improve patient care and decrease morbidity and mortality rates in addition to contributing to more research globally. It will allow healthcare costs to be analyzed, outcomes to be measured in greater detail and finally processes and performance from the caregiver to be measured.

Bottom line - Meaningful Use, accountable care and the patient centered medical home processes are changing the industry from pay for performance to a payment for quality of care model. The detailed coding system the ICD-10 code set offers will support this move to improve our country’s quality of care. Without ICD-10 the multitude of changes impacting our healthcare industry will be ineffective.

Know Your Terminology: M.D. vs. D.O.

gdavie@hielix.com (Gavin Davie) — Tue, 29 Nov 2011 18:11:16 +0000

Understanding the terminology you will encounter working in the healthcare industry is critical; and the first set of acronyms you face will be on the front door of any medical practice you visit, “Medical Offices of John Smith, M.D. and Jane Doe, D.O.”

What is the difference between a Doctor of Medicine (M.D.) and a Doctor of Osteopathic Medicine (D.O.)? In the past 20 years the lines between the two schools of medicine have become increasing blurred and up until about 15 years ago not all major healthcare organizations credentialed D.O.s into their system. For young people entering medical school the trend indicated those who were not accepted into a MD program turned to and were accepted into the D.O. program. Statistics supported this fact with the difference in GPA and MCAT scores that were recorded between the two entities. In 2010 the average MCAT and GPA for students entering US-based M.D. programs were 31.1 and 3.67 respectively and 26.49 and 3.47 for the D.O. curriculum [Source]. However, the scores do not tell the whole story. It is widely known that osteopathic programs are more likely to accept non-traditional students - who are older, coming into medicine as a second career, and are non-science majors. The D.O. medical schools believe the older applicants are more emotionally sound and culturally competent, thus making them a better candidate to becoming a physician [Source].

M.D.s study allopathic medicine – the practice of conventional medicine that uses pharmacologically active agents or physician interventions (surgery) to treat or suppress symptoms or pathophysiologic processes of disease or conditions [Source].

D.O.s study osteopathic theories which encompass all the benefits of conventional medicine including prescription drugs, surgery, and the use of technology to diagnose disease and evaluate injury; combined with the added benefit of hands-on diagnosis and treatment through a system of therapy known as osteopathic manipulative medicine. D.O. students take approximately 200 additional hours of med school to study manipulation therapy [Source]. D.O.s view the patient as a “total person” and treat the whole body rather than treat a specific illness or symptom.

There are several educational similarities and requirements between the two licenses.

Both D.O.s and M.D.s typically have a four-year undergraduate degree prior to medical training.
Both D.O.s and M.D.s have spent four-years in medical education. Both take the MCAT and are subject to a rigorous application process.
D.O.s, like M.D.s, choose to practice in a specialty area of medicine and complete a residency program ranging from 3-7 years. Some D.O.s complete the same residency programs as their M.D. counterparts.
M.D. students take the USMLE exam and D.O. students take the COMLEX exam. Both must pass a state licensing examination to practice medicine.

Understanding the difference between an M.D. and D.O. practitioner is not as significant as appreciating the time and dedication it took these individuals to achieve the status of “Doctor.” Both M.D.s and D.O.s are recognized and licensed in all 50 states. There are 20 schools of Osteopathic medicine in the U.S., 126 accredited U.S. M.D.-granting medical schools, and 16 accredited Canadian M.D. granting schools.

For further reading visit American Association of Colleges of Osteopathic Medicine (AACOM) and the American Association of Medical Colleges (AAMC).

Look for future installments of our primer in medical terminology for VARs! Once we complete the series we will offer a quick reference guide in PDF for for those we are interested, be sure to sign up to receive updates in the right hand column!

Know Your Terminology: Health IT 101

gdavie@hielix.com (Gavin Davie) — Thu, 17 Nov 2011 15:46:40 +0000

Understanding the basic terminology is a critical piece of the puzzle towards establishing creditability with a physician and/or practice manager. The medical community is experiencing industry wide changes at a rapid pace and the vendors who have done the research and understand those changes will gain a competitive advantage over their less informed competitors.

Pursuing the development of a robust healthcare vertical can provide fulfillment and opportunity on many levels, but being successful requires knowledge of certain related terms. To perform successfully, healthcare vendors/professionals should have an understanding of key medical-related terminology dealing with the physician, their office and overall operations of the practice. Understanding the various front line terminologies can help with your credibility in the eyes of the practice and ultimately, the sale.

First we'll offer a brief overview for the uninitiated and the delve into some specific terminology. Most vendors typically are working within physician practices to assess their IT hardware infrastructure and are involved in the selection and purchase of an Electronic Health Record (EHR). Incentive money is available from The Centers for Medicare and Medicaid (CMS) as a result of the Health Information Technology for Economic and Clinical Health Act (HITECH) and Meaningful Use (MU).

The Medicare and Medicaid EHR Incentive Programs provide a financial incentive for the "meaningful use" of certified EHR technology to achieve health and efficiency goals. By putting into action and meaningfully using an EHR system, providers will reap benefits beyond financial incentives-such as reduction in errors, availability of records and data, reminders and alerts, clinical decision support, and e-prescribing/refill automation. For eligible professionals, there are a total of 25 meaningful use objectives. To qualify for an incentive payment, 20 of these 25 objectives must be met.

There are 15 required core objectives.
The remaining 5 objectives may be chosen from the list of 10 menu set objectives.

(Source: CMS.gov)

Eligible professionals (EPs) are eligible for up to $44,000 per provider if participating with Medicare or up to $67,000 if participating with Medicaid. Eligible professionals under the Medicare EHR Incentive Program include:

Doctor of medicine or osteopathy
Doctor of dental surgery or dental medicine
Doctor of podiatry
Doctor of optometry
Chiropractor

Eligible professionals under the Medicaid EHR Incentive Program include:

Physicians (primarily doctors of medicine and doctors of osteopathy)
Nurse practitioner
Certified nurse-midwife
Dentist
Physician assistant who furnishes services in a Federally Qualified Health Center or Rural Health Clinic that is led by a physician assistant.

For additional requirements please reference: CMS.gov

To be classified as an EP the provider must posses a National Provider Identifier (NPI) which is a unique 10-digit ID number issued to healthcare providers in the United States by CMS.

Physicians who choose to participate with MU must select an EHR that has been certified by the Office of the National Coordinator (ONC). ONC is a division of the Office of the Secretary (OS) who has been tasked with implementing and coordinating the exchange of electronic health information nationwide.

For the past 15 years physician practices have been submitting medical claims through their practice management system (PM) or claims are outsourced to a billing and collections agency. Typically the practice is paying 5-7% of collections to that outside agency. Claims are generated from information gathered from the super bill which is created using documentation from the patients' healthcare visit by the clinician. The information from the super bill is then entered into the PM, which generates a claim. Claims are submitted to a third party entity or clearinghouse. Claims are then "scrubbed" which means they are verified for eligibility, demographics, physician NPI number, and diagnosis codes (International Classification of Disease or ICD-9) are matched with the Current Procedural Terminology (CPT) codes.

The current ICD-9 code set is changing effective January 1, 2013 and clinicians will be expected to generate claims using the ICD-10 code set. Because the ICD-10 code set is more specific and detailed oriented, the adoption of a certified EHR prior to tackling a coding change can make this a much smoother process for the practice. Evaluation and management codes (E&M) are a subset of CPT codes that specifically address the level of care given to the patient. For example, an established patient who had 15 minutes of "face" time with the doctor for the follow up care of an infection could bill an E&M code of 99213. This code indicates to the health insurance carrier that the presenting problem was low to moderate in nature. Documentation off the patient visit is critical in the event of an audit. Most clinicians follow a structured set of documentation guidelines called SOAP notes. "The SOAP note (an acronym for subjective, objective, assessment, and plan) is a method of documentation employed by health care providers to write out notes in a patient's chart, along with other common formats, such as the admission note. Documenting patient encounters in the medical record is an integral part of practice workflow starting with patient appointment scheduling, to writing out notes, to medical billing" (Source: Wikipedia).

The Place of Service Code (POS) is a key indicator on a claim that designates whether or not an EP qualifies for the incentive money and also determines the level of reimbursement. The POS is noted on the claim, this informs the health insurance carrier where the services were rendered. For example, 11 - indicates physician's office, 21 - in-patient facility (patient is admitted into the hospital and is staying longer than 23 hours), 22 - outpatient facility, 24 - urgent care facility. If over 80% of the physicians care is administered to patients with a POS 21, the physician does not qualify to participate with MU.

A benefit to having an EHR is Computerized Physician Order Entry (CPOE), an application that enables providers to enter medical orders such as treatment plans, prescriptions, labs and referrals into a computer system. E-prescribing (eRX) is another application that works with the EHR to help reduce medical errors. eRX allows physicians to electronically send an accurate, error free, legible medication order to the patient's pharmacy of choice. Utilizing the eRX feature will help satisfy one of the MU requirements.

Hielix Apps Announced!

gdavie@hielix.com (Gavin Davie) — Wed, 02 Nov 2011 16:43:52 +0000

We have a new site heading your way in the near future! HielixApps.com will be launched with some major enhancements to the EHR Roadmap as well as a brand new app! Here are the details in some quick bullets, read on below if you want even more details.

Completely new, streamlined look for the EHR Roadmap!
The EHR Roadmap will be integrated with our brand new app - the Healthy Practice Checkup (HPC).
The brand new app (HPC) supports the IT reseller channel in their efforts to assess the clinical workflows and operational processes of a physician practice and make recommendations to enhance efficiency, reduce costs and drive additional revenue. These recommendations ultimately lead to long-term value and sustainability for the practice and an enhanced perception of the VAR as a trusted advisor.
Updates to the EHR Roadmap: We've doubled the amount of 2011 certified products from which the selection engine can choose (there are new solutions out everyday!)
Updates to the EHR Roadmap: We've updated the decision engine to include more considerations and more detailed functionality.

Below we've laid out some common questions and answers to give you some more detailed information:

What will happen to HielixEHR.com?
As part of the launch of HielixApps.com, the web URL HielixEHR.com will be phased out. However, the EHR Roadmap itself will continue to live under HielixApps.com.

I have private label version of the EHR Roadmap, what will happen to it?
Those VARs with private label versions of the roadmap will continue to use the private label version of the Roadmap during and after the launch of HielixApps.com. However, after launch we will migrate all the private label versions of the Roadmap into the look and feel of HielixApps.com based on your agreement with Hielix. This will also allow you to begin to utilize the HPC application as well.

When will the launch of HielixApps.com take place?
There is no official date in place for launch but currently we anticipate the launch of HielixApps.com taking place in mid to late December. Once an official launch date is announced we will be sure to let you know about it.

Please be sure to bookmark HielixApps.com as you won't want to miss the exciting developments in the future!

How to Stay Informed in the Healthcare Industry

gdavie@hielix.com (Gavin Davie) — Fri, 21 Oct 2011 19:28:21 +0000

Deadlines are looming, incentive requirements are changing and overall the healthcare industry is in a constant state of flux. So how do HIT resellers and healthcare professionals both clinical and administrative stay on top of the changes and demands that are being introduced into the healthcare arena?

In the world of HIT resellers staying current is critical to the success of the organization. The ability to stay ahead of the curve and anticipate the needs of healthcare clients is certainly a challenge but one that can be met with the help of a few different websites. A good place to start to become familiar with the specifics that pertain to your client’s specialty is the site of the ONC or The Office of the National Coordinator for Healthcare Information Technology, the premier site for updates regarding changes in the healthcare industry. The next stop is the Centers for Medicare and Medicaid Services. Search under “Meaningful Use”, “EHR Incentive Programs” or “Physician Incentive Programs” for updates that are specific to physicians. Additional places for top line information would include:

Healthcare Informatics (@HCInformatics)
Healthcare IT News (@hitnewstweet)
EHR Outlook (@ehroutlook)
the FierceHealthcare Network specifically FierceHealthIT (@FierceHealthIT)

For clinical personnel it is always a wise decision to become a member of your specialty association, register and request weekly or even daily updates be sent to your email. For example: Nurses can access the American Nursing Association (@nursingworld), this website offers government policy updates and addresses the needs of nurses in their professional settings as well as patient care. Another website dedicated to nursing is the American Academy of Nursing Executives (@tweetAONE). Nursing has become so specialized that there are resources available directed to the different specialties. Nurse.org provides multiple lists of websites dedicated to these specialties and are listed by state.

The resources available to physicians are endless and again our recommendation would be to first join the association related to your specialty. One example would be the American Academy of Family Physicians (@aafp). This is site is dedicated to Family Practitioners and offers: updates on clinical practices and research; continuing medical education opportunities and certification; tips on how to run a practice; the opportunity to become a member of advocacy groups; and updates on healthcare reform.

For non-clinical personnel whose primary focus is information systems in the healthcare environment, I recommend becoming a member of HiMSS, Healthcare Information Management Systems Society. From the site: "HIMSS is a cause-based, not-for-profit organization exclusively focused on providing global leadership for the optimal use of information technology (IT) and management systems for the betterment of healthcare."

Additional resources that could meet the needs of all of the above listed professionals include:

All these sites offer insight into the healthcare industry, provide crucial information surrounding the industry and government changes as well as additional resources.

As a side note, the Medical Group Management Association (@mgma) is a very involved organization dedicated to non-clinical personnel whose primary focus is practice management. This group is very proactive and provides support to various government advocacy programs through their Government Affairs Department.

Finally, there are a number of focus groups via LinkedIn that will open doors for education and professional affiliations. Trying to stay informed and involved can become a full-time job but when you take the time to do the legwork and get connected you will discover the sites and associations will provide a great benefit your day-to-day responsibilities.

Not eligible for incentive money? Should you consider purchasing a certified EHR?

gdavie@hielix.com (Gavin Davie) — Fri, 21 Oct 2011 13:16:52 +0000

All healthcare providers and facilities should consider transitioning to electronic medical records, which is obviously a significant project and expense. However, if you have the proper credentials you can participate in the government incentive programs and work towards partial financial compensation. The proper credentials include being classified as an EP (eligible professional), which according to Medicare and Medicaid is:

A doctor of medicine or osteopathy
A doctor of dental surgery or of dental medicine
A doctor of podiatric medicine
A doctor of optometry
A chiropractor
Doctors of medicine and osteopathy
Certified nurse midwife
Nurse practitioner
Physician assistants practicing in a Federally Qualified Health Center of Rural Health Center.

Those who fall outside the EP distinction are not eligible for incentives, some of those are, for example: physical therapists, mental health professionals or even a home health agency.

If you are not an EP why should you consider purchasing a certified EHR?

Simple: Certified electronic health records are the future of healthcare.

Besides an infusion of incentive money (which non-EPs won’t be receiving) electronic health records serve a variety of purposes beyond the ability to share data between providers. There are significant financial savings incurred when migrating from paper charts to electronic charts. The benefits realized from the built in intelligence in the practice management coding applications are enough to justify the transition alone.

Coupled with financial considerations are the time saving considerations, which include the ability to manage personal and professional time better, the ability to analyze appointment times, patient flow and staff responsibilities. The potential for improved patient care is another very compelling reason to purchase an EHR. Today, certified EHRs are demonstrating improved coordination of care and patient quality of care through fewer clinical errors, management of medication and allergy lists, test results, referrals and overall disease management.

Finally, it is anticipated that in the near future primary care physicians, pediatricians and specialist will begin referring to other providers who can receive clinical summaries electronically and in turn will be able to provide clinical summaries back in the same standard format. The ability to communicate with all providers will make you a member of that patient’s care team. Additionally, private insurers and large employers are rewarding physicians and healthcare providers for adopting EHRs with their own incentive programs. Cigna highlights physicians who are certified by the National Committee for Quality Assurance’s Physician Practice Connections (PPC) program in their physician directory. PCC is a program that requires the use of EHRs to e-prescribe, track test results and offer e-mail communication with patients.

When contemplating software, systems providers should only consider certified EHRs as all certified products have one thing in common - interoperability. A strict set of standards and criteria were developed by the government so EPs and hospitals may be assured the systems they adopt are capable of performing the required functions. The Office of the National Coordinator states, “Providers and patients must be confident the electronic health information technology (health IT) products and systems they use are secure, can maintain data confidentially, can work with other systems to share information, and can perform a set of well-defined functions.” A certified EHR will provide the peace of mind to the healthcare provider as well as the patient that patient data gathered is secure and can be transmitted between all providers.

Lastly, let’s not forget about the consumer. As the popularity of EHRs continue to grow, their use will soon be expected by all patients from their healthcare providers. Once your customer’s start evaluating healthcare providers based on who can coordinate their care with an electronic record and who cannot, it will be too late to decide.

Hospital/Physician Alignment: Pros and Cons

hstearns@hielix.com (Hattie Stearns) — Wed, 14 Sep 2011 19:55:43 +0000

Hospital and physician alignment creates new work environments that can yield rewards for both physician and hospital. On the other hand, there are aspects of the new relationship that need to be addressed before the doctor reports for work on day one as a hospital employee. Expectations of the new relationship between physician and hospital need to be clear and well defined.

Hospitals hire physicians in an attempt to capture market share and increase referrals. Physicians become employees of the hospital to help balance their work and family time as well as potentially increase annual income and have fewer concerns regarding insurance reimbursements and payment in general.

Concerns on the hospital side of the equation range from financial to cultural. The increased employee count must be budgeted for appropriately. Increase in total salaries and benefits due to the enlarged employee base along with additional malpractice exposure and corresponding insurance premiums must be accurately forecast. Also to note, highly specialized physicians that previously may have never existed in the hospital setting now are employees with special risk management needs and associated premiums. An increase in operational costs results from the increase in the number of physicians and support staff. Additionally an often overlooked challenge for hospitals is that they must evaluate existing management structure and culture and subsequently implement change to manage and motivate physicians that previously were CEOs of their own practice.

Items for physicians to evaluate when considering whether or not to become employees of a hospital or health system include:

Understanding the hospital politics and the hierarchies of the business world that are involved
Are there any expectations the physician will assume a role in management with the corporate operations?
There are financial rules/constraints that might include impacting ownership in outside ancillary facilities. Physicians as owners of ancillary facilities are not an accepted business practice in the eyes of a hospital for legal and ethical reasons. The physician will lose the autonomy of being employer/owner and will no longer be making management decisions surrounding his/her practice; he/she will be expected to adhere to the policies & procedures of the hospital.
Also to be considered is the physician’s relationship role with the surrounding community.

As with any change in employment and ownership status there are pro and cons to be considered. The cultural changes alone warrant strong deliberations for all parties involved.

What can a single practitioner do with all the data? Another benefit to having an EHR.

hstearns@hielix.com (Hattie Stearns) — Mon, 29 Aug 2011 13:22:48 +0000

There are multitudes of patient data that are generated from medical practices, hospitals, rehab centers, etc. This data encompasses demographics and the tracking and trending of care, treatments and diseases. This data is the primary source of data for Medicare, Medicaid and commercial insurance carriers via claims submissions from healthcare facilities. But what does the additional data that is captured through EHRs mean to a single practitioner?

Data is a valuable resource. It is generated from the practice management (PM) module and provides a multitude of reports, primarily accounts receivable. A physician can have an immediate snapshot of how long it is taking insurance carriers to process and pay claims and for a patient to pay their bill. Physicians know how much has been billed, what has been billed, and when to expect reimbursement. The PM module can provide patient demographics, median age of population, number of patients seen per day, week or month. It also knows what services have been billed and which code is used the most frequently - this information can be drilled down to specifically the amount of revenue each provider is producing. The PM system also tracks appointments scheduled, no shows and types of appointments that are being filled or left open.

With the introduction of an EHR into a practice, clinical data will now be more accessible and with it, improved quality of care. The very basic information that an EHR system should be able to track is: medication prescribed, dosages, outcomes and usage, patient vitals and weight fluctuations. Also, lab and X-Ray orders can be generated and monitored as to whether or not a patient is compliant. For example, with this preliminary information and a few simple keystrokes a physician can have the history of a cardiac patient’s blood work, what medications they have been prescribed, any drug interactions, and whether or not the medication is effective. Additionally, at the physician’s fingertips are social and family histories, diet and any pertinent history that can be analyzed. This information can be reviewed in a matter of moments and as a result of this clinical documentation the physician can make solid treatment recommendations. The end result is improved quality of care.

The not so obvious benefits from having an EHR include: tracking how long appointments take with certain diagnosis. Which provider spends more time with their patients, which employee is addressing patient messages in a timely manner, which patients are more involved in their own care. The system can also tell the practice who is in need of a flu shot and who received sample medication that has now been recalled, for example.

Additional benefits include:
Increased awareness and marketing opportunities, increased communication with patients, generate health maintenance alerts, appointment reminders along with, improve practice productivity, reducing operational costs, improved documentation, solving the E/M compliance issues and on-line medical access.

However, data gathering is not automatic and requires a conscientious staff to generate and produce quality information. Data integrity must be maintained through completeness, consistency, accuracy and timeliness and with the acknowledgement that without quality documentation the data can be skewed and inadequate.

The opportunities that sound data can generate are endless.

– Lisa Smaga, Director of Ambulatory Consulting

Conquering the Practice Manager

hstearns@hielix.com (Hattie Stearns) — Mon, 22 Aug 2011 12:57:35 +0000

As you may have noticed from our previous series on the strategies for selling into physician practices, we can’t overemphasize the importance of the role of the practice manager. Previously we’ve discussed their role but never some specific strategies on how to get your foot in the door. We’d love to hear your stories, successes and failures in the comments below.

A physician’s office is a busy environment and it is the responsibility of the practice manager (PM) to juggle all the balls and keep the process running smoothly. It can also be a challenging role if the manager assumes additional responsibilities when another employee is out. It also falls to the PM to manage patient flow, which in turn means managing the physician’s time, which in itself, can be a challenge.

The practice manager therefore assumes the role of the gatekeeper and monitor of which outside distractions, e.g., vendors, are allowed access to the physician. The first step in the process is to capture a moment with the manager in order to gain a few minutes with the physician.

So how does a reseller capture a few minutes of the practice manager’s time? Perseverance and presenting forth a kind friendly approach will work wonders towards your goal. Call ahead and determine when there are no patients waiting to be seen. Most physician offices turn off the phones for lunch or have a ½ day set aside with no patients scheduled to take the time to manage the multitude of paperwork and messages the week has generated. My suggestion is to stop by and introduce yourself during this time, leave a business card and possibly a brochure, nothing else.

When you are face to face with the manager, ask probing questions, leave materials behind, and provide information with no obligation attached. As a former practice manager I can tell you from experience that if you consumed too much of my time and you are pushy, you aren’t getting in the door. I dealt all day long with grumpy patients, pushy patients, unhappy staff and frustrated physicians - a kind face went much further with me.

I had one vendor who managed to wiggle her way into the staff’s heart by leaving small boxes of cookies every week, they loved her and convinced me to set an appointment to hear what she had to offer. The result, she became our new printer for two reasons; she was kind, had good references and I was tired of dealing with the old printing company who had poor customer service. Perseverance combined with leaving key product information will generate more good will between you and the practice manager than overwhelming him/her in the first meeting.

And finally, always, always, represent and deliver quality customer service - which is crucially important and unfortunately not the norm in many industries. Demonstrate to the practice manager through your diligence and kindness that your word is good and you will be an asset to them during these transitional times.

– Lisa Smaga, Director of Ambulatory Consulting

Selling to Physicians: A Multi-Part Strategy, Part 4

hstearns@hielix.com (Hattie Stearns) — Thu, 11 Aug 2011 13:18:19 +0000

Today’s post wraps up our series on Strategies: Selling to Physicians, we encourage you to read the previous parts as well: Part 1, Part 2, Part 3.

A well-informed reseller adds value to a medical practice by helping to answer the many unanswered questions surrounding healthcare IT. The goal of any value added reseller should be to become the first choice as the solution provider to the medical practice for these issues both in knowledge and services/products.

Some current hot topics that will help facilitate this are:

ePrescribing: deadlines and penalties
the conversion from ICD-9 to ICD-10
Meaningful Use: deadlines and penalties
questions concerning the purchase of an EHR

Understanding the ins and outs of Meaningful Use certainly can work to your advantage, as the opportunities for providing assistance are endless. The definition and requirements to participate in Meaningful Use cannot be over emphasized. It is imperative that resellers understand the eligibility requirements, for example: A provider does not have to be contracted, or “accept assignment” from Medicare to participate. Physicians may be inclined to believe that since they do not participate with Medicare they are not eligible. The criteria states a physician must be submitting part B claims for their services to Medicare. If a physician, (MD or DO) satisfies the criteria as an “eligible provider” and provides care for any Medicare patient there exists the possibility that they can participate in Meaningful Use. The incentive money is paid to the physician based on the total amount of Medicare claims they submit - up to $24,000 a year. Many physicians are assuming they are not eligible to participate in Meaningful Use and a knowledgeable reseller can reveal the possibilities and acquire a new client.

For a more in-depth explanation see the CMS FAQ site.

Medicare also provides a questionnaire to help determine eligibility here.

Another gray area on the list of hot topics are the details surrounding the purchase of an EHR and the “assumed” high price tag. In reality there are a significant number of very efficient, affordable, certified systems available. Helping the physician to understand cloud-based systems could be the first step in clarifying these misconceptions about price. A cloud-based EMR/EHR system also raises the questions regarding security and once again this is a huge opportunity for the reseller to provide answers and solutions that will promote a trusting relationship between the reseller and medical practice.

The opportunities to help clarify the questions emerging in the healthcare industry are significant, and knowledgeable individuals are very much in demand. Take the time to become familiar with these hot topics and be prepared to answer whatever questions come your way.