Information Technology | The Leading Business Education Network for Doctors, Financial Advisors and Health Industry Consultants

On PHI Security Breaches

Posted on August 28, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

New HHS Regulations

[By Staff Reporters]

Effective September 23, 2009, new regulations issued by the U.S. Department of Health and Human Services (“HHS”) will require covered entities to notify affected individuals and HHS following the discovery of a breach of patient information. These regulations are more expansive than other notification laws that may already exist. Under these new regulations, covered entities must analyze every privacy and/or security incident to determine whether a notification requirement exists and then satisfy detailed notice requirements.

Breach Defined

According to Garfunkel, Wild and Travis PC, a “breach” may be defined as the unauthorized acquisition, access, use or disclosure of unsecured Protected Health Information (“PHI”) which compromises the security or privacy of the PHI. It is important to note that this definition of breach is broader than most state notification laws under which most covered entities have already been operating for a number of years. While state notification laws may only require notification when there is an unauthorized disclosure of social security numbers or other specific kinds of personal information, under these new Federal regulations, unauthorized access, acquisition, use or disclosure of any PHI, not just social security number, is a potential breach. Furthermore; unauthorized uses of PHI, not just access or disclosure, requires notification.

Assessment

For more info: http://www.gwtlaw.com

Conclusion

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Filed under: Glossary Terms, Health Law & Policy, Information Technology | Tagged: Department of Health and Human Services, EHRs, EMRs, Garfunkel, HHS, HIPAA, PHI, security breach, Wild and Travis, www.healthdictionaryseries.com | 3 Comments »

Let’s Think about Vitality GlowCaps for a Moment

Posted on August 28, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Lights, Ring Tones and E-mails – Oh My!

By Dr. David Edward Marcinko; MBA, CMP™

[Editor-in-Chief]

Vitality Inc, is a new firm that reports to address the billion-dollar adherence problem for pharmaceutical brands, retail pharmacies, and healthcare providers with a simple device — an Internet-connected pill cap.

What it Is

Vitality GlowCaps illuminate, play a melody, and even ring a home phone so patients don’t forget to take their pills. They can send weekly emails to remote caregivers, create accountability with doctors through an adherence report, and automatically refill prescriptions. Vitality reports to improve medication adherence, health, and peace of mind.

Video: http://rxvitality.com/glowcaps.html

Name Droppers

According to its website, Vitality is currently working with researchers at Harvard Medical School and the Center for Connected Health on a study to measure the impact of the GlowCaps CONNECT system.

Vitality is the only company with a product designed to tackle the combination of factors that conspire to cause non-adherent behavior.

Overkill

Our society is now at the point of paying obese patients to diet and exercise [they don’t seem to recognize the benefit], paying public school children to study [they don’t seem to recognize the benefit], and now using internet enabled technology to help patients remember to take their own medication [they don’t seem to … yada, yada, yada].

A Reasonable Query?

But, may one reasonably ask; is this admittedly “very cool” technology overkill? THINK: RFID tags for wrong extremity surgery; when common sense and a magic marker might do just as well? Sure, there may be some modicum of benefit here for elderly patients and select other reasons. But, does the marginal cost outweigh the marginal benefit? Or, is this technology really a solution in search of an exaggerated “problem” that just may involve slack personal responsibility? And, most importantly, who will pay for it?

Assessment

Vitality Inc, leverages deep expertise in customer research, wireless consumer electronics, web services and behavioral psychology. Vitality’s patent pending solution is said offer each patient the optimal mix of intervention, feedback, reminders, accountability, education and incentives to improve their ongoing medication adherence. But, does it really improve health, and at what cost? Can’t we solve the “problem” of pill non-compliance cheaper and easier?

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Tell us what you think. Any early adopters out there, and ready to opine? Or, give em’ a click and tell us what you think! http://rxvitality.com Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Filed under: Drugs and Pharma, Ethics, Information Technology, Op-Editorials, Videos | 3 Comments »

About HealthDataRights.org

Posted on August 27, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Mitigating the Unintended Consequences of HIPAA

By Staff Reporters

Many patients and pundits opine how today’s HIPAA regulations [written in the relative paper based stone age] say that while doctors must provide a copy of your records, they can take a month to do so. And, if they want, they can say that’s not enough and take another month. However, when a patient needs medical care; that time-line is not acceptable.

Enter a Website and Start a Movement

According to the website www.HealthDataRights.org, in an era when technology allows personal health information to be more easily stored, updated, accessed and exchanged, the following rights should be self-evident and inalienable. We the people:

Have the right to our own health data.
Have the right to know the source of each health data element.
Have the right to take possession of a complete copy of our individual health data, without delay, at minimal or no cost; if data exist in computable form, they must be made available in that form.
Have the right to share our health data with others as we see fit.

Assessment

These principles express basic human rights as well as essential elements of health care that is participatory, Health 2.0 appropriate and in the interests of each patient. No law or policy should abridge these rights.

Conclusion

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Filed under: Ethics, Health Law & Policy, Information Technology | Tagged: EHRs, electronic medical records, EMRs, health data, health information technology, HIPAA, HIT, IT, www.HealthDataRights.org | Leave a comment »

Henry Louis Gehrig, eMRs and Healthcare Reform

Posted on August 26, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

What’s the “Iron Horse” Got to Do with Health IT?

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

According to UPI reports from Charlestown, WVa on August 24 2009, at least 1,200 veterans across the country were mistakenly told by the Veterans Administration [VA] that they suffered from a fatal neurological disorder.

Link: http://www.msnbc.msn.com/id/32541579/ns/health-health_care/

Panicked Veterans

One of the leaders of a Gulf War veterans group is reported to have said that panicked veterans from the states of Alabama, Florida, Kansas, North Carolina, West Virginia and Wyoming contacted the group about the error. Denise Nichols, the vice president of the National Gulf War Resource Center, reportedly blamed a “coding error” for the mistake. In medicine, we call this a “false positive.”

About Henry Louis “Lou” Gehrig

Henry Louis “Lou” Gehrig (June 19, 1903 – June 2, 1941), born Ludwig Heinrich Gehrig, was an American baseball player in the 1920s and 1930s; chiefly remembered for his prowess as a hitter, the longevity of his consecutive games played record and the pathos of his tearful farewell from baseball at age 36, when he was stricken with a fatal disease. Of course, Gehrig was known as the “The Iron Horse” for his durability. Yet, the irony is that Amyotrophic Lateral Sclerosis [ALS], or Lou Gehrig’s disease [sometimes also called Maladie de Charcot] is progressive and fatal. Lou died in 1941 after developing the illness. Will the same death-spiral happen to eHRs and Obama care?

Link: http://www.lougehrig.com

Assessment

Having rotated through the VA system as a young medical student back-in-the-day, I have never been a fan. It smacked of socialized medicine and government plutocracy, and was never a leading-edge example of domestic healthcare, in my informed opinion. Recent HIPAA administrative, security, IT and clinical medical errors are well known. So, to blame the mix-up on an insurance billing and “coding error” seems somewhat disingenuous. Especially now, at a time when eMRs and the Obama Administration’s healthcare reform itself is being vigorously debated by the citizenry. I mean, are there no human checks and balances? Would there be any human intervention if a public healthcare policy was adopted?

Of course, we have written about military medicine previously on this Medical Executive-Post, and devoted an entire channel to it. And, I do realize that more than fifty percent of us receive similar governmental care in some form, or another [Medicare, Medicaid, CHIPS, the Indian and Prison Healthcare Systems, etc].

Link: https://healthcarefinancials.wordpress.com/category/military-medicine/

Nevertheless, shall we give a new moniker to this mistake? How about “Lou Gehrig’s coding error”, and document it in our www.HealthDictionarySeries.com

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Is it even fair to relate this “isolated incident” to the current healthcare reform debate, the eMR conundrum and/or similar discussions on health Information Technology [IT]? Tell us what you think. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Filed under: Breaking News, Ethics, Health Law & Policy, Information Technology, Military Medicine, Op-Editorials, Touring with Marcinko | Tagged: ALS, amyotrophic lateral sclerosis, CHIPS, CMS, david marcinko, Denise Nichols, EHRs, EMRs, health information technology, healthcare reform, HIPAA, Indian Health Service, Iron Horse, IT, Lou Gehrig, Medicaid, medicare, National Gulf War Resource Center, nationalized medicine, obama, Obama Health, Prison Health Service, public health plan, socialized medicine, VA, Veterans Administration | 1 Comment »

BCBS-TX Reverses NPI Policy

Posted on August 24, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Victory at Last

[By Darrell K. Pruitt; DDS]

Every now and then, I enjoy little victories. My war with BCBS-TX started when they began declining to pay their clients’ claims if they originated in my office. Since I’m not a HIPAA-covered entity, I didn’t volunteer for an arbitrary National Provider Identification number.

The behemoth insurance company not only successfully drove away some of my long term patients, but their clever policy blocked my access to their pool of clients who were led to believe their dental insurance was good everywhere – until my office manager had to tell them otherwise. BCBSTX is a sleazy company simply because it lies to its clients as policy.

Successful Claims

In the last two weeks, my office manager has successfully filed a couple of claims and it appears that unless payment is blocked in the next day or so, BCBSTX no longer requires Texas dentists to have NPI numbers.

Asessment

That’s nice, but I want more. I want the state CHIP program to drop its NPI requirement as well. Why limit access to dental care to the poor because of a number that only helps insurers. I’m just getting started, Texas.

Conclusion

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Filed under: Health Insurance, Health Law & Policy, Information Technology, Managed Care, Pruitt's Platform | Tagged: BCBSTX, Darrell Pruitt, DDS, dentists, health insurance claims, HIPAA, National Provider Identification number, NPI, Texas CHIP | 3 Comments »

My Favorite Health 2.0 Experience from McDonalds

Posted on August 20, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Meet the Schwieterman’s

By Dr. David Edward Marcinko; MBA, CMP™

Back in 2005, we published the second edition of our popular textbook: the Business of Medical Practice. And, we are now working on the third edition. At the time however, I was fortunate to have a colleague from the Microsoft Corporation pen our Foreword, now reprinted below for your review.

Link: http://www.springerpub.com/prod.aspx?prod_id=23759

What a Family Tradition!

My favorite story came from Dr. Thomas Schwieterman, a fourth-generation physician working in the same medical office his great grandfather established in 1896 in the town of Mariastein, Ohio. From those same historic environs, Schwieterman has used Microsoft Access to create his own physician assistant application.

The Schwieterman Family Physicians practice kept him so busy that he was wondering how he could keep up with his patient caseload. Schwieterman wanted a faster way to handle prescriptions, provide medical information, and record data for his patient records. He walked into a McDonald’s restaurant one day and had an idea.

The Epiphany

“I ordered a cheeseburger and fries and watched the person at the counter touch the screen of the cash register a few times, and realized the order was getting transferred back to the food preparation area, and that by the time I paid, my order was ready,” he said. “I thought to myself: ‘That’s what I need!’” He searched for commercially available solutions, but when he couldn’t find an exact match for his needs, and when he found prices steep for a small private practice, he decided to create his own – using Access. He also called upon a friend with a Master’s Degree in electrical engineering to help on the coding. His creation boosted his income by 20 percent – “Which was important because we pay more than $60,000 a year for malpractice insurance even though our clinic has never been sued since it was founded 107 years ago.”

Assessment

What my friends at Microsoft especially like about this story is that when Dr. Schwieterman’s colleagues tried his program, liked it, and suggested he try to sell it, he put together a PowerPoint presentation – and landed a partnership agreement with a major healthcare supply and services corporation to market his ChartScribe solution.

Conclusion

So, the pressures facing physicians are great, but so are their resources. Information technology is one resource, this book is another, but the greatest of all is the innate curiosity and drive to discover and create that seems to be so much a part of those who are drawn to this noble profession.

Ahmad Hashem; MD, PhD

Global Healthcare Productivity Manager

Microsoft’s Healthcare Industry Solutions Group

Microsoft Corporation

Redmond, Washington

Conclusion

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Filed under: Book Reviews, iMBA, Inc., Information Technology, Media Mentions and PR, Practice Management, Recommended Books | Tagged: Access, Ahmad Hashem, Business Medical Practice, ChartScribe, david marcinko, DO, eHs, EMRs, Mariastein, MD, medical records, microsoft, Ohio, PhD, PowerPoint, Schwieterman, Thomas Schwieterman | Leave a comment »

Integration of Hospital Automatic Data Collection Technologies

Posted on August 19, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Review of Automatic Data Collection Equipment

By David J. Piasecki, with
Hope Hetico; RN, MHA

While hardware costs of automatic data collection [ADC] equipment continue to come down for hospital and healthcare organizations, the cost of integration will often prove to be the project buster. Software and integration costs will often be several times the cost of the hardware, especially in smaller health system operations where only a few devices will be used. Integration of ADC technologies is also far from standardized.

www.HealthcareFinancials.com

Example:

For example, when implementing a system with portable terminals, one integrator may create a program on the terminals that will write directly to the file on the host system, another may create programs on a separate server to do this, another may write or modify a program on your host system and use terminal emulation software, and another may use a screen mapping tool to reformat an existing program to be used on the portable device. So, make sure to speak with several integrators to ensure the best solution. Also, make sure to participate heavily in equipment selection and program/process design (prompts, data input) to ensure a system that provides the highest levels of accuracy and productivity.

Real-Time Locator System

A real-time locator system (RTLS) uses RFID technology that provides the objects they are attached to the ability to transmit their current location. The system requires some type of RFID tag to be attached to each object that needs to be tracked, and RF transmitters/receivers located throughout the facility to determine the location and send information to a computerized tracking system. While it sounds like a great way to eliminate “lost” inventory, the systems are still too costly for most inventory-tracking operations and are more likely to be used to track more valuable assets.

Screen Mapping/Screen Scraping

This software provides the functionality to change the arrangement of data fields on a computer screen that accesses a mainframe computer program. Screen mapping is frequently used in combination with terminal-emulation software to “remap” data fields from a standard mainframe program to be used on the smaller screen of a portable hand-held device.

Speech-Based Technology

Speech-based technology, also known as voice technology is really composed of two technologies: (1) voice directed, which converts computer data into audible commands, and (2) speech recognition, which allows user voice input to be converted into data. Portable voice systems consist of a headset with a microphone and a wearable computer.

Terminal Emulation

Software used on desktop and portable computers is available that allows the computer to act like a terminal connected to a mainframe system. If you have a networked desktop PC and are accessing mainframe programs (green screen programs) you are using terminal emulation. Terminal emulation is also a common method used to connect portable computers (as in pharmacy bar-code ADC systems) to mainframe software.

Warehouse Management System

Computer software designed specifically for managing the movement and storage of materials throughout the healthcare system warehouse or chain of command generally controls the following three operations: (1) put-away, (2) replenishment, and (3) picking. The key to these systems is the logic to direct these operations to specific locations based on user-defined criteria. Warehouse Management Systems (WMSs) are often set up to integrate with ADC systems.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Can you think of any other data integration technologies? Tell us what you think. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Filed under: Career Development, Experts Invited, Glossary Terms, iMBA, Inc., Information Technology, Practice Management | Tagged: ADC, automatic data collection, CPOE, David Piasecki, HIT, hope hetico, hospital information technology, IT, real-time locator system, RFID, RTLS, screen mapping, Speech-Based Technology, Warehouse management systems, WMS | 1 Comment »

ME-P Healthcare Reform Survey?

Posted on August 18, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Off-Road Touring with Dr. Marcinko [Part V]

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

About Marquette, Michigan

As our ME-P readers are aware, Marquette Michigan has a population of 20,714, and is the UP’s largest community. In addition to being a population center, it serves as the regional center for education, health care, and outdoor recreation. This regional draw is particularly evident due to Northern Michigan University and Marquette General Hospital [MGH]. Naturally, during my recent tour there, I was able to visit both small and large medical practices, clinics and hospitals. Everywhere, the topic of conversation was the Obama Administration’s vision of domestic healthcare reform. And so, after unofficially asking local residents on their feelings in the matter, we are pleased to offer this survey to all readers and subscribers to our Medical-Executive Post.

About Off Road with Dr. Marcinko

These sporadic off-road segments will continue through-out my 2009 summer promotional tour. On the one hand, formal attendance at several engagements was a bit sparse because of the death of several recent celebrities and entertainer types. On the other hand, local book stores and sponsors noted a spike in our CD and book sales, as well as interest in our online www.CertifiedMedicalPlanner.com program and premier quarterly guide: Healthcare Organizations [Journal of Financial Management Strategies] www.HealthcareFinancials.com

Part IV: https://healthcarefinancials.wordpress.com/2009/08/13/off-road-touring-with-dr-marcinko-part-iv/

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Filed under: Drugs and Pharma, Health Economics, Health Insurance, Information Technology, Managed Care, Professional Liability, Quality Initiatives, Surveys and Voting, Voting Polls | Tagged: CDHCP, consumer directed healthcare plans, EHRs, electronc medical records, EMRs, healthcare reform, HSAs, malpratice tort reform, medical records, MSAs, national health care, obama, pharmaceutical pricing, single payer, socialized medicine | 1 Comment »

About Practice Fusion and Free eHRs

Posted on August 17, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

A Web Based Concept in the Clouds

By Staff Reporters

Practice Fusion is a firm that reports to address the complexities and critical needs of today’s healthcare environment by providing a free, web-based electronic Health Record (eHR) application to physicians.

America’s Fastest Growing EHR community

Practice Fusion is also a fast growing electronic Health Record community. Founded in 2005, they are rapidly expanding and adding new users regularly. Over 18,000 physicians and practice managers in 50 states currently use Practice Fusion’s electronic Health Record.

Online and Free

Practice Fusion stands out in a marketplace dominated by complicated, expensive and often inefficient eHR services. Their user-friendly eHR is reported to be activated in less than five minutes, with no downtime or extensive training; eliminating the difficult conversion process that has become an industry-standard.

Secure and Reliable

The firm understands the mission-critical nature of their application. Practice Fusion’s electronic Health Record is developed for the highest levels of security and performance with world-class data centers equipped with best-in-class technology to securely house sensitive data.

Assessment

Although Practice Fusion is a young company, they are led by a well-established team of healthcare and technology veterans. Practice Fusion is directed by a group of investors and medical practitioners who believe in the power of electronic Health Records. Investors include Band of Angels, Salesforce.com and Felicis Ventures. So, give the site a click, and tell us what you think! www.PracticeFusion.com

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Comments from users and early adopters are especially appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Filed under: Information Technology, Practice Management | Tagged: CCHIT, EHRs, electronic health records, electronic medical records, EMRs, health information technology, medical records, practice fusion, www.practicefusion.com | 1 Comment »

Kelly Mclendon RHIA censors D. Kellus Pruitt DDS

Posted on August 16, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

By Darrell K. Pruitt; DDS

Dateline: 8.15.09

Dear Kelly Mclendon, Registered Health Information Administrator

You are beginning to make me feel insulted, and I will not have that. I just noticed that the last two comments I submitted to your Website, www.spacecoastmedicine.com, on August 9 and 10, are still “awaiting moderation.”

http://www.spacecoastmedicine.com/2009/08/electronic-records-for-all-patients-mandated-by-2014.html#comment-89

(For clarity, the comments which scared Mr. Mclendon are copied below)

Over five days have passed, and I want you, your readers and my readers to know that I spent a lot of time preparing those two pieces exclusively for you at your invitation for comments. You are as sincere as I am, aren’t you?

When I’ve caught others in the squeeze you might be experiencing, several have pleaded that the censorship was an innocent oversight, and did the right thing immediately by posting everything I send them (include this comment, please). And then again, there are a few slow-learning, command-and-control types who think they cam still somehow control the content of their Websites. Like you, Kelly, an anonymous dentalblogs.com editor whom I call “Nancy” by default, also informed me that my comments were awaiting indefinite moderation. What a foolish, rookie mistake that proved to be. For example, if you google “dentalblogs.com,” my article “Dentalblogs.com hates D. Kellus Pruitt DDS” is their 4^th hit. It seems to be very popular.

How’s this for the title of a comment that should make it to your first page by Monday: “Kelly Mclendon RHIA censors D. Kellus Pruitt DDS”? Please, no phone calls.

D. Kellus Pruitt; DDS

Dateline 8.9.09

I’m sure physicians’ businesses are no different than dentists’ when it comes to the liability of data breaches – especially considering the giddy, mindless momentum of HITECH-empowered HIPAA. If a computer is stolen in a burglary, compromised by a dishonest employee who sells IDs on the side, or otherwise hacked, and the dentist reports the tragedy according to the letter of the law, it inevitably means bankruptcy even before the feel-good fines are levied by HHS (HIPAA) and the FTC (Red Flags Rule) for not having required irrelevant documentation of administrative trivia in order. What were our lawmakers thinking?

I guess the HIPAA blunder proves that when politicians, insurers and healthcare IT entrepreneurs get together in vendor clubs like CCHIT, the only government-approved eHR certification authority, they can mandate damn well any law that suits their needs.

Allscripts CEO Glen Tullman, who is an influential friend of Barack Obama as well as a Trustee of CCHIT told Bloomberg.com reporter Alex Nussbaum in an interview almost a year ago that providers should make the financial commitment “to ensure that doctors have some skin in the game.”

Glen Tullman is only one reason our nation’s healthcare IT industry stinks from the top down.

D. Kellus Pruitt; DDS

Dateline: 8.10.09

Thank you, Kelly Mclendon, for providing a rare venue to possibly clear up a few items of uncertainty about eHRs in dentistry. First of all, if a technological advancement such as eDRs does not pay for itself, even with government subsidies, who pays for it? That seems like a quick way to increase the costs of dental care – and for what? How do dental patients benefit from expensive HIT solutions when the telephone, fax machine and US Mail serve us fine?

Digitalization of records offers no benefits to dental patients. Only stakeholders who would grab our patients’ money benefit from HIT. Everyone else loses. Trusting, naive dental patients lose the most.

Electronic dental records are expensive hazards. If you can think of a lame reason for them, please let me hear it. You can bet I’ve crushed it before. I’ve been down this road with others many, many times.

Within a week, the government will price computerization smooth out of dentistry. Over 90% of dentists have patient identities on their computers today. If HIPAA is enforced, with or without the Red Flags Rule, I predict that less than half of the nation’s dentists will be computerized a year from now.

As for your argument that eHRs somehow provide up-to-date and otherwise superior medical histories for dental patients, think about this: If someone changes a paper medical history, it leaves a paper trail. If an insurance thief alters allergies on a digital record to suit his or her own needs, nobody in the emergency room can tell. Whoever said “Paper kills,” lied. It is a catchy PR pitch, though.

Conclusion

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FINANCE: Financial Planning for Physicians and Advisors
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Filed under: Ethics, Health Insurance, Information Technology, Managed Care, Op-Editorials, Practice Management, Pruitt's Platform | Tagged: Alex Nussbaum, Allscripts, Bloomberg.com, CCHIT, Darrell Pruitt, DDS, dental records, Dentalblogs.com, DMD, EHRs, electronic dental records, EMRs, FTC, Glen Tullman, Health I.T., healthcare information technology, HHS, HIPAA, HITECH, IT, kelly McLendon, obama, red flag rules, Registered Health Information Administrator, RHIA, www.spacecoastmedicine.com | 12 Comments »

Health Plan Management Navigator

Posted on August 16, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

August 2009 Edition

By Douglas B. Sherlock; CFA, MBA

Linked below is the August 2009 edition of Plan Management Navigator. In this month’s edition, we update readers on the results for the Blue Cross Blue Shield universe, and provide product breakouts, summary functional area breakouts as well as expense trends. Cost increases are lower this year than last, though higher if product mix is considered. Twenty-two Blue Cross Blue Shield Plans serving 31.3 million members participated in this year’s benchmarking study. Growth in Information Systems and Medical Management costs explained more than 40% of the total increase.

Link: Navigator August 09

Sherlock Expense Evaluation Report

This analysis is based on materials from our Sherlock Expense Evaluation Report (SEER) for Blue Cross Blue Shield Plans. Additional information about SEER is available at http://www.sherlockco.com/seer.shtml or by contacting us.

Assessment

In coming weeks, Plan Management Navigator will summarize other results of this year’s performance benchmarking studies. We expect to publish Medicare and Medicaid editions in late August or early September. Independent / Provider-Sponsored plan results were published two weeks ago in Plan Management Navigator and the associated presentation and transcript are found at http://www.sherlockco.com/

Conclusion

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BCBS-TX Must Talk to D. Kellus Pruitt DDS

Posted on August 14, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Do My Manners Bother Anyone?

[By Darrell K. Pruitt; DDS ]

I posted this on the Dallas Morning News Website in response to an article about BCBSTX downsizing due to the economy.

http://economywatchblog.dallasnews.com/archives/2009/08/health-care-losing-jobs.html

Dear Jason Roberson – Reporter – The Dallas Morning News

As a dentist on the east side of Fort Worth whose patients have been harmed by BCBSTX, I say the fewer clients BCBSTX has, the safer Texans are. Changing dentists causes fillings.

Of HIPAA and the NPI Number

It wouldn’t surprise me that until about now, you and most of your readers have never heard of the HIPAA-mandated National Provider Identifier (NPI) number. And it probably doesn’t make much sense to you when I say that it is BCBSTX policy not to process their clients’ dental claims if they come from a dentist who doesn’t have an NPI number, like me. BCBSTX’s horrible policy has not only decreased my number of new patients, but the arbitrary rule also caused a couple of dozen of my long-term patients – who were perfectly satisfied in the comfortable dental home I provided them – to leave me for dentists with NPI numbers. Please note that the 10 digit identification number does nothing improve the quality of care. It only benefits BCBSTX. And did I mention that changing dentists causes fillings?

Not Accepting Assignment

Even in these tough economic times, I choose to no longer accept BCBSTX. My ethics-based decision hurts me financially, but that is how much I sincerely despise BCBSTX for its NPI policy. Unless Texas Health CEO Doug Hawthorne or a spokeswoman for BCBSTX like Margaret Jarvis or Ross Blackstone mans up to their deception really soon, I hope to help the wheels fall off of BCBSTX as an example to other insensitive CEOs who harm my patients by selling their clueless bosses discount dental plans with no quality control. Special bastards like me proudly volunteer to clean up the neighborhood, just for grins. As a matter of fact, a few sports fans and I are hoping one of the recently laid off BCBSTX employees is named Wilma, who on May 1, 2008 was known as an “overall supervisor” for BCBSTX in the dental claims department. I’m certain that CEO Hawthorne knows her. Then again, it wouldn’t surprise me to learn that he is unconcerned about dentistry.

A Pubic Invitation

I am publicly inviting Wilma to come forward – even as whistleblower if she still has her job – and share with us the motivation behind the alleged lies she told me during our conversation. Even now, as I listen to our recording, I consider it an entertaining and educational conversation between two people who both know a BCBSTX overall supervisor who brought talking points to an argument. Nevertheless, even while trapped between honesty and her job, Wilma proved to be a devoted employee – willing to risk her own reputation for her boss. The way she sticks with defending a defenseless policy, at times it sounds like the NPI number actually makes sense to her. Then you think, “Surely she is smarter than that.”

Assessment

I know that coming at the end of one of the strangest comments you have ever attracted, it is appropriately ballsy that I say that there’s a new sheriff in town, Jason. And disrespect around my niche is no longer tolerated if I have anything to do with it. I’ll shoot holes in BCBSTX to help it crash sooner if it will cause fewer Texans experience unnecessary dentistry. How important to one’s oral and systemic health is continuity of care when virtually all oral problems are caused by neglect? Is BCBSTX dental insurance worth the hidden price? Thank you for the opportunity to air out my opinion.

Conclusion

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Filed under: Career Development, Health Insurance, Information Technology, Managed Care, Op-Editorials, Pruitt's Platform | Tagged: BCBSTX, Dallas Morning News, Darrell Pruitt, Darrell Pruitt DDS, DDS, dentist, DMD, Doug Hawthorne, Fort Worth, HIPAA, Jason Roberson, Margaret Jarvis, National Provider Identifier, NPI Number, Ross Blackstone | 6 Comments »

Borges versus Kvedar Video eHR Debate

Posted on August 12, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

The Great HIT Debate

[By Staff Reporters]

All ME-P subscribers and readers are invited to watch a debate between Dr. Alberto Borges and Dr. Joseph Kvedar. In the original broadcast, by HCPLive, both participants were asked some very interesting questions about health information technology [HIT] when posed to them. And so, if you were unable to attend the live event, it is now re-broadcasted in podcast form for your review.

About Alberto A. Borges; MD

Al Borges is Founder and CEO of the MS Office eMR Project http://www.msofficeemrproject.com He is the project author, visionary and main content developer for the independent website. As a board certified physician, he practices oncology, hematology, and internal medicine in Arlington, Virginia. He is also a clinical professor at the George Washington University Medical School. Dr. Borges is a colleague and thought-leader for the ME-P

About Joseph C. Kvedar; MD

Joe Kvedar is the Founder and Director of the Center for Connected Health http://www.connected-health.org The Center is known for applying communications technology and online resources to increase access and improve the delivery of quality medical services and patient care outside of the traditional medical setting. A division of Partners HealthCare; the Center for Connected Health works with Harvard Medical School-affiliated teaching hospitals, including Massachusetts General and Brigham and Women’s Hospitals. Dr. Kvedar is also a board-certified dermatologist and Associate Professor of Dermatology at Harvard Medical School

Podcast Link: http://www.hcplive.com/hcplive/great_debate

Assessment

Feel free to email questions, or to post follow-up comments, for all our viewers to consider and respond. The principals are asked to weigh-in, as well.

And the Winner is … ?

Conclusion

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Filed under: Information Technology, Interviews, Point-Counter Point, Practice Management, Videos, Voting Polls | Tagged: Al Borges, ARRA, Brigham and Women’s Hospitals, Center for Connected Health, EHRs, electronic medical records, EMRs, George Washington University Medical School, Harvard Medical School, health information technology, HIT, HITECH, IT, Joseph Kvedar, Massachusetts General, obama, Office eMR project, Partners Healthcare, personal medical records, protected health records | 7 Comments »

ADA President and Broken Promises

Posted on August 11, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

The Future President

By Darrell K. Puritt; DDS

The election for a future ADA president occurs the first week in October in Hawaii at the 2009 annual meeting. A couple of days ago, the ADA News Online posted the ADA President-elect candidates’ statements.

http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=3133

All three sound like they support meaningful dialogue with membership: Candidate Dr. Raymond Gist says one of his goals is: “To protect and preserve ownership of the intellectual property of the ADA while demonstrating transparency and fostering an understanding of how our system works.” Candidate Dr. William Glecos says “My first goal will be to coordinate and improve our communication efforts within the ADA. To make sure we are engaging all our members and imparting a sense of connection and transparency.” Candidate Dr. Marie Schweinebraten says “… communication, internal and external, must be improved to respond in today’s world … barriers must be eliminated to allow member input and volunteer involvement when solving specific issues.” I’ve seen candidates use these same buzzwords before, but not mean them. Dentistry is being severely threatened right now, and I’m too young to retire. So I want to see a future leader confident enough to walk through fire with me on behalf of my patients.

Promises from ADA President-elect candidates have been very disappointing so far. Past President Dr. Mark Feldman, President Dr. John Findley and President-elect Dr. Ron Tankersley each promised “transparency.” Feldman and Findley broke their promises very early, and so far, Tankersley has done no better. Nine months ago I invited Dr. Tankersley to a conversation about the future of electronic dental records and he chose to insult me with silence rather than respond. I took it personally, Ron, and I’ll never forget it. Because all three of these presidents are simply rude people, it wouldn’t bother me to never ask any of them for friendship.

So do you think our fresh leaders are any more sincere about transparency with membership? Or are they also hoping to be safely elected. This could be an opportunity for one or more of the three to break loose and be counted as a brave leader… or not. Let me show you what Feldman, Findley and Tankersley have gotten us into. Below is a list of duties expected of dentists with NPI numbers that came out today on ANCO Online. If any of you three candidates have the courage to respond to my challenging comments about what I consider to be a perfect example of a renegade department, jump right in. Concerned members need to be warned about the courage we can count on. If you cannot defend the Department of Dental Informatics, just say so. We’ll all be better off. And on truth, we can build. What an opportunity for you! I bet one could easily gain the delegates’ attention by doing the right thing, even if it is unpopular at first to those who may have helped you to power.

Responding to this article in a respectful, professional way could be just what it takes to get a person elected to the highest position in the American Dental Association. That’s what you intensely want, isn’t it? You just have to recognize what I am spelling out for you, Raymond, William and Marie. Just look at the growing discontent with the ADA on the Internet. Whoever is the first to show sincerity and courage, will become a hero to those of us who feel betrayed by those we once trusted. Victory will never be easier. I’ve had a look around. Believe me when I tell you that things are soo bad that even I could be a contender. Don’t make me run for the job.

Here is the first issue for discussion if you are interested: For dentists who were persuaded by the ADA Department of Dental Informatics to quickly volunteer for the 10 digit identifying number, let me ask you this: If you had been told what ADA employees are paid to tell you, which you can read below, would you have applied for an NPI number? And if you were forced to apply for a number by a managed care contract with BCBSTX, Delta Dental or other discount dentistry broker, would that be considered an unfair business practice?

Let’s look at fairness: Who does the NPI number help? Dental patients or BCBSTX? Or perhaps the ADA? We were told again and again in ADA News Online articles written by Arlene Furlong that the best reason for the NPI number was convenience. She said office managers would love it because it would replace numerous identification numbers. When one reads the list of NPI obligations a dentist volunteers their office manager for, all those other numbers don’t seem so bad after all. Why was HIPAA so important that the ADA Department of Dental Informatics forced employees under its supervision to intentionally mislead membership? Does the ADA work for dentists and their patients or for CMS? There you go, Dr. Raymond Gist, Dr. William Glecos and Dr. Marie Schweinebraten. It’s your turn now. If you have the guts to step up to a challenge, it could pay off big. Besides, even if you get elected without first responding to my concerns doesn’t mean you’ll get rid of me. Oh heaven’s no.

D. Kellus Pruitt; DDS

http://anco- .blogspot.com/2009/08/asco-coa-cms-palmettoj1mac-news.html

**** CMS NEWS ****

This message is for health care providers, particularly physicians and other practitioners, who have obtained National Provider Identifiers (NPIs) and have records in the National Plan and Provider Enumeration System (NPPES). The Centers for Medicare & Medicaid Services (CMS) recommends that each health care provider, including individual physicians and non-physician practitioners: · Secure and maintain their own NPPES account information (i.e., User ID, Password, and Secret Question/Answer) for safety and accessibility purposes. Health care providers should maintain the confidentiality of their User ID, password, and Secret Question/Answer in order to protect their NPPES information from unauthorized access. Reset their NPPES passwords at least once a year.

See the NPPES Application Help page at https://nppes.cms.hhs.gov/NPPES/Help.do and select the ‘Reset Password Page’ for applicable rules. Those rules indicate the length, format, content and requirements of NPPES passwords. Review their NPPES records in order to ensure that the information reflects current and correct information. Covered health care providers are required to update their NPPES information within 30 days of the effective date of the change.

Viewing NPPES Information Health care providers, including physicians and non-physician practitioners, can view their NPPES information in one of two ways: (1) By accessing the NPPES record at https://nppes.cms.hhs.gov/NPPES/Welcome.do and following the NPI hyperlink and selecting Login. The user will be prompted to enter the User ID and password that he/she previously created. If the health care provider has forgotten the password, enter the User ID and click the “Reset Forgotten Password” button to navigate to the Reset Password Page. If the health care provider enters an incorrect User ID and Password combination three times, the User ID will be disabled. Please contact the NPI Enumerator at 1-800-465-3203 if the account is disabled or if the health care provider has forgotten the User ID. OR (2) By accessing the NPI Registry at https://nppes.cms.hhs.gov/NPPES/NPIRegistryHome.do.

The NPI Registry gives the health care provider an online view of Freedom of Information Act (FOIA)-disclosable NPPES data. The health care provider can search for its information using the name or NPI as the criterion. Information regarding NPPES data that are FOIA-disclosable can be found at http://www.cms.hhs.gov/NationalProvIdentStand/ by selecting ‘Data Dissemination’. Please note: Business Mailing Address and Business Practice location information (full address and corresponding telephone numbers) are key data elements that are FOIA-disclosable.

Health care providers should not report their residential address unless it is their Business Mailing Address or Business Practice location. The NPPES data appearing on the NPI Registry cannot be deleted; however, it can be updated or changed. Updating NPPES Information Health care providers, including physicians and non-physician practitioners, can correct, add, or delete information in their NPPES records by accessing their NPPES records at https://nppes.cms.hhs.gov/NPPES/Welcome.do and following the NPI hyperlink and selecting Login. The user will be prompted to enter the User ID and password that he/she previously created.

Please note: Required information cannot be deleted from an NPPES record; however, required information can be changed/updated to ensure that NPPES captures the correct information. Certain information is inaccessible via the web, thus requiring the change/update to be made via paper application. The paper NPI Application/Update Form (CMS-10114) can be downloaded and printed at http://www.cms.hhs.gov/cmsforms/downloads/CMS10114.pdf.

Deactivating the NPI Health care providers, including physicians and non-physician practitioners, can deactivate their NPIs if the NPIs are no longer required or needed. Reasons for deactivation include retirement, business dissolved, or death of the health care provider. A request for deactivation must be submitted via paper application. The paper NPI Application/Update Form (CMS-10114) can be downloaded and printed at http://www.cms.hhs.gov/cmsforms/downloads/CMS10114.pdf.

Health care providers should review the instructions located on the application regarding deactivations in order to properly complete the deactivation request. The Power of Attorney or Executor of the Will may complete the application for deactivation due to death of the health care provider.

Need More Information?

Providers can apply for an NPI online at https://nppes.cms.hhs.gov or can call the NPI enumerator to request a paper application at 1-800-465-3203. Visit CMS’ dedicated NPI web page at www.cms.hhs.gov/NationalProvIdentStand for additional NPI information.

Channel Surfing

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Filed under: Career Development, Ethics, Health Insurance, Health Law & Policy, Information Technology, Managed Care, Op-Editorials, Practice Management, Pruitt's Platform | Tagged: ADA, American Dental Associaion, ANCO, Arlene Furlong, BCBSTX, Darrell Pruitt, DDS, delta dental, Department of Dental Informatics, DMD, doctoroogle.com, HIPAA, john findley, Marie Schweinebraten, mark feldman, NPI, NPPES, OSHA, Raymond Gist, Ron Tankersley, William Glecos | 8 Comments »

Hospital Automated Data Collection

Posted on August 10, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Understanding Data Capture Technologies

By David J. Piasecki, with
Hope Hetico; RN, MHA

Automated data collection (ADC), also known as automated data capture, automated identification (AutoID) or automated identification and data capture (AIDC), consists of many different technologies. Bar codes, voice systems, RFID, OCR, laser scanners, vehicle mounted and wearable computers are all part of ADC management and hospital inventory activities.

www.HealthcareFinancials.com

Six-Figure Projects

However, the fear of six-figure project costs often prevent many small to mid-sized hospitals and healthcare systems from taking advantage of these technologies. The key to implementing cost-effective ADC systems is to know what technologies are available and the amount of integration needed to implement them. Applying this processing knowledge in a healthcare organization will help in developing the scope of any project. Limiting projects to or prioritizing by those applications that have a high benefit/cost ratio allows these operational improvement technologies within a reasonable budget.

Example:

For example, adding a keyboard-wedge bar-code scanner to an existing personal computer (PC) or blade terminal in a nursing station is a very low-cost method for applying ADC to existing hospital reporting applications. This type of hardware is inexpensive and the only real programming required is to add a bar code to the proper form (work order, pick and delivery slip, etc).

Review of the ADC Technologies

Some of the current hospital data capture technologies include the following:

a. Bar Codes

b. Bar-Code Scanners

Laser or CCD

Auto-Discrimination

Keyboard-Wedge Scanners

Fixed-Position Scanners

c. Portable Computers

d. Batch versus Radio Frequency

e. Hand-Held Devices

f. Vehicle-Mounted Devices

g. Wearable Systems

h. Voice Technology

i. Optical Character Recognition

j. Light Systems

Assessment

Driven by a need for improved data capture, asset management, staff mobility and standardized medication administration to name a few benefits, hospitals are likely to invest much more heavily in ADC and Wi-Fi technologies over the next five years, according to this new research report.

Link: http://www.eweek.com/c/a/Health-Care-IT/WiFi-Healthcare-Systems-to-Hit-49B-878082/

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Tell us what you think. Can you think of any other hospital data capture technologies? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Filed under: Experts Invited, iMBA, Inc., Information Technology, Practice Management | Tagged: ADC, AIDC, AutoID, automated identification and data capture, automatic data collection, bar codes, David Piasecki, FRID, HIT, hope hetico, Information Technology, IT, keyboard wedge scanners, laser scanners, OCR, PC, voice technology, Wi-Fi, wi-max, www.healthcarefinancials.com | 2 Comments »

About HealthSpottr.com

Posted on August 6, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Leading Minds, Leading Change, Leading Healthcare

By Staff Reporters

As a newly launched collaborative website, www.HealthSpottr.com believes in the future of healthcare. According to the site, it exists to showcase emerging innovations and the new faces of leadership who will bring this future to you. Co-founders Carleen Hawn and Lawrence Leisure believe that the powers of technology, design, and business model and care delivery-innovation can transform healthcare. Mostly, they opine that the passion which drove doctors into medicine, engineers into technology, artists into design, and entrepreneurs into business; can be leveraged to bring this future to us all.

Inauguration

In its inaugural issue, HealthSpottr debuted something special: a list of the 100 most creative and influential innovators working in healthcare today. Since the future of healthcare is coming; they highlighted some of the people who will deliver it to you.

Assessment

In a few days HealthSpottr will debut a Weekly Digest, a regular brief on new technology, a business model, a new therapy or scientific discovery with the potential to shift the healthcare economy; so stay tuned!

Channel Surfing?

Have you visited other websites of interest to ME-P subscribers? If you find one that facilitates like-minded idea exchange, and links our community together, please let us know!

Conclusion

And so, your thoughts and comments on this Medical Executive-Post, and HealthSpottr are appreciated. Give them a click and tell us what you think? And, feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Filed under: Alerts Sign-Up, Breaking News, Experts Invited, Health Economics, Information Technology, Media Mentions and PR, Nominations Sought, Research & Development | Tagged: 100 healthcare innovators, Carleen Hawn, Health Economics, healthcare business, healthcare technology, HealthSpottr, Lawrence Leisure | 1 Comment »

About EHRWatch.com

Posted on July 30, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

A New Online Virtual Collaborative

By Staff Reporters

www.EHRWatch.com is a new online community dedicated to developments in electronic health records [eHRs], including practice, funding, product integration, standards developments and trends in implementation. The new site features blog posts, polling, commenting and a weekly e-newsletter.

A Collaborative

www.EHRWatch.com is designed to encourage community participation, interaction, collaboration and reaction. Whether you need to select and implement an EHR solution or make sure your current system meets the requirements and timeline necessary to receive the Obama Administration’s ARRA, and HITECCH, stimulus incentives, the site may offer the products, information, services and expertise to help.

Assessment

Visit www.EHRWatch.com to read the latest posts and join the virtual community. Just give em’ a click, today!

Conclusion

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Filed under: Breaking News, Information Technology, Practice Management | Tagged: ARRA, CCHIT, EHRs, electronic health records, electronic medical records, EMRs, healthcare reform, HITECH, obama | 2 Comments »

About MeaningfulUse.org

Posted on July 23, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

A Dedicated Terminology Website

By Staff Reporters

Understanding and defining the new era of healthcare information technology in America.

The ARRA and HITECH concept of “meaningful use” for e-MRs is nebulous and ill defined. This new website is intended to be a collaborative destination site in order to promote the national dialogue and education around the term, “meaningful use”, by providing the HIT community a single-central location to access resources, influence and discuss the definition of “meaningful use” and learn how to take advantage of the HITECH stimulus funds.

Assessment

According to the site, registration for the www.MeaningfulUse.org discussion board is only used for the purpose of posting and will not be used for any marketing purposes. The site is supported by the Association of Medical Directors of Information Systems (AMDIS) and sponsored by Compuware Corporation.

Conclusion

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Filed under: Breaking News, Career Development, Glossary Terms, Health Economics, Information Technology | Tagged: AMDIS, ARRA, Association of Medical Directors of Information Systems, CCHIT, Compuware Corporation., economic stimulus funds, HIT, HITECH, IT, Mark Leavitt, meaningful use, www.healthcarefinancials.com, www.healthdictionaryseries.com, www.MeaningfulUse.org | 13 Comments »

ADA / IDM Breakup – You Heard it Here First

Posted on July 14, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Will CareCredit be the Next ADA Subsidiary to Fail?

I saw a warning sign last week.

By Darrell K. Pruitt; DDS

My aggressive writing hobby has understandably brought me in hard contact with public relations people whose job is to insulate good ol’ boys from accountability – even if it means taking hits for the team and staining their reputations. Let’s face the fact we all of us involved in public relations know but don’t dare discuss: Depending on the ethics of one’s employer, PR professionals are sometimes used up like expendable pawns. And avoiding bylines for press releases no longer shields anyone from accountability.

I often silently stalk PR employees (Gasp!) on the Internet who work for sleazy companies just to better understand them. I’ve discovered that it is not hard to find and exploit the weaknesses of those whose heart isn’t behind selling their employer’s product. Sometimes all it takes is a fistful of transparency to cause defenseless representatives to completely shut up, and that alone makes our neighborhood safer. Committee-approved methods of evasion are as simple-minded as committees, so it doesn’t take long to figure them out – exposing the shameful ethics of those who sign off on the use of lame, institutional trickery.

For example, here’s a very popular, traditional PR trick: If a huge business entity such as the ADA has bad news they can no longer keep secret from customers, professional PR-types will advise their bosses to post bad news on a Friday to soften the blow. When traditional leaders find that they can no longer sidestep accountability, delaying accountability until a busy news day is the next best thing one can purchase. Even though the tricks seem simple, there are people who study evasion science as part of obtaining a degree in marketing.

So how good is the ADA’s PR team? How much time did ADA members’ employees buy for leaders before they had to quietly acknowledge an expensive failure?

On July 10, a Friday, “ADA/idm to phase out service” was posted on ADA News Online without a byline. (Another PR trick: When the ADA posts an orphan without a name, it means someone is ashamed of the bastard.)

http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=3655

“ADA Business Enterprises, Inc. (ADABEI), a wholly owned ADA subsidiary, announced today that ADA Intelligent Dental Marketing (ADAidm) of Salt Lake City, one of its joint venture companies, is no longer able to provide marketing services to its customers due to significant production and operational difficulties.”

Now the ADA must refund money to members in a depressed market. Could this embarrassment for our professional organization have been quietly avoided instead of delayed and magnified? I personally started seeing clues of CEO Trajan King’s reticence long ago, and warned ADA leaders in Chicago about my concerns. Nobody ever responded to my numerous, sincere warnings.

These are highly critical times on Capitol Hill and our patients trust us to represent their welfare. Dentists are their last hope, because there is nobody else who cares. Practicing dentists are solely responsible for assuring the benevolence of our niche market, and we are losing control publicly. Disasters like the ADA/IDM make the ADA look foolish to Congress, and word gets around fast on the Internet.

This morning, I read an article posted on The NY Times titled “Study Measures the Chatter of the News Cycle, “ written by Steve Lohr.

http://www.nytimes.com/2009/07/13/technology/internet/13influence.html?_r=1

Researchers at Cornell used powerful computers and sophisticated algorithms to accomplish an unprecedented analysis of news articles and comments on the Web during the 2008 presidential campaign. They studied the characteristics of the news cycle by scanning 1.6 million mainstream media sites and blogs for repeated phrases and tracking the history of their appearances.

Lohr writes: “The researchers’ data points to an evolving model of news media. While most news flowed from the traditional media to the blogs, the study found that 3.5 percent of story lines originated in the blogs and later made their way to traditional media.”

The study also shows that traditional news outlets are still quicker than blogs by 2.5 hours. I should now point out that the Cornell study was performed using data from very popular, huge news items collected during a presidential election – not hidden, niche news like dentistry’s.

If you are involved in the dental industry, where are you more likely to read time-sensitive news about our profession first? In an ADA publication, or from D. Kellus Pruitt; DDS?

Whereas traditional media is 2.5 hours quicker with popular topics, I scooped traditional ADA News Online by three weeks when I posted “ADA/idm – A bad union after all?” on the PennWell forum.

http://community.pennwelldentalgroup.com/forum/topics/adaidm-a-bad-union-after-all

So what about the warning sign I saw concerning CareCredit – a wholly-owned subsidiary of the ADA?

When Trajan King, former CEO of the defunct ADA/IDM partnership refused to acknowledge my questions, I immediately suspected something was terribly wrong with the union of my non-profit professional organization and his for-profit Utah advertisement company. Six months later, my fears were confirmed. Now then, I hope it grabs someone’s attention that I see the same warning signs coming from the ADA’s CareCredit business. Note this date: July 13, 2009.

On Thursday, July 9, CareCredit purchased a press release on dentalblogs.com: “CareCredit Adds 24-Month, No-Interst [sic] Payment Plan” (no byline).

http://www.dentalblogs.com

Since dental problems only get worse, I consider the idea of extending credit to dental patients is a benevolent thought during these hard financial times. I also say that the offer appears to have been put together out of generosity and not greed like the ADA/IDM disaster. However, at 4:54 pm on the same day that CareCredit’s press release was posted, I submitted a difficult question for the anonymous author of the piece who works PR for CareCredit – and is an ADA employee.

“If the Red Flags Rule is not delayed for the third time in three weeks, how will it affect those who offer Care Credit?”

I was given the hopeful response “Your comment is awaiting moderation,” but days later there is no sign that my question is being considered at all. Please, oh please ask yourself: What could CareCredit leaders be hiding and how much will it end up costing ADA membership?

I will not be ignored by anyone. Today, I submitted two follow-up questions on dentalblogs.com. I considered warning the anonymous moderator that this is being simulposted on other blogs, as well as described on Twitter, but then I thought, why spoil the fun? Let the leaders of the ADA Business Enterprises, Inc. (ADABEI) get word of my e-Attack from their colleagues. Won’t they be surprised!

Oh, and for those who are wondering what happened to ADA/IDM CEO Trajan King – he quit.

Dear Dentalblogs.com moderator:

On July 9 at 4:54 pm, I submitted a sincere question concerning how the Red Flags Rule will affect ADA members who sign up for CareCredit. Instead of posting it with the promise of an answer, you regretfully chose to censor an ADA member. Today, July 13, I have a second and third question: Why did you ignore my first one and who is your boss?

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Filed under: "Doctors Only", Breaking News, Career Development, Ethics, Health Insurance, Information Technology, Marketing & Advertising, Media Mentions and PR, Pruitt's Platform, Research & Development | Tagged: ADA, ADA Business Enterprises, ADA/IDM, ADABEI, American Dental Association, CareCredit, Darrell Pruitt, dentists, IDM, Intellignet Dental Marketing, red flag rules, Steve Lohr, Trajan King | 12 Comments »

Blue Cross/Blue Shield of Texas on Facebook

Posted on July 6, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Let’s Have Some Fun!

[By Darrell K. Pruitt; DDS]

Hello, sports fans. Have you missed me? It’s been about five days since I posted a comment that didn’t follow an article authored by someone else.

My last one was “Pruitt’s Platform – Introduction to an Adventure.” It’s unusual for me to go so long between posting stand-alone pieces, but after putting that title to my introduction, and compounding the challenge by promising to never push out bland stuff, I set my standard high. It took me a few days, but I finally found a deserving old target on a brand new venue that I think will hold your interest. BCBSTX and I have an intense history, so I assume they charged someone anonymous and shy to follow everything I write. I welcome you, whoever you are. Yea, you. The one hiding in the dark corner, justifiably afraid to utter a peep. Keep your pointed head down, friend, and try not to wet your nice pants.

BCBSTX, you should be disappointed to learn that I found your Facebook account. Even for a fat dinosaur, you are an especially thick and slow-moving easy target. I recommend you just surrender now to transparency and start the confessions and reparations before the lawsuits become huge and the lawyers profit more from your collapse than the Texan dental patients you’ve harmed. Let me remind you that the repeal of the McCarran-Ferguson Act is just around the corner, and we all know about the rumor (started by me) that there are attorneys across the nation just waiting to file class-action lawsuits against BCBS for unfair business practices, including restraint of trade for using the NPI number to drive satisfied patients from dental homes they preferred. Finally, BCBSTX will be subject to the same anti-trust laws as the doctors they fear, and I am here to make sure BCBSTX feels the pain. Look what happened to Dell Computer when that huge dinosaur was surrounded by Jeff Jarvis and Dell Hell. The game I’m playing with you is a more nimble, improved variation of Dell Hell, using fewer vulgar words.

You should know by now you are too fat and too slow to hide from me and the sports fans I bring. Nevertheless, I am always fair in telling my targets my goals before I go on to accomplish them. Here is what I am going to do to you, BCBSTX: I intend to pull your anonymous, unaccountable butt out into the wide open for everyone to see – especially the lawmakers you lobby and support with generous donations. Did you know that there is a rumor (also started by me) that some of those same lawmakers you consider friends are aware of most of what I write on the same day I post it? The transparency I bring will eventually trap and crush you, BCBSTX. Or, you can immediately come out and meet me for an open discussion about the inevitable reformation of dental insurance in Texas – putting humble, obedient bureaucrats with names under the direct control of dentists and patients. And of course, it is understood that in order to save Texas citizens millions of dollars in healthcare expense, there will be drastic downsizing of BCBSTX Dental, just like Delta Dental and ADA/IDM are experiencing right now. That means no more bonuses and no more frivolous pursuits like publishing, printing and mailing to Texas dentists those expensive self-serving brochures joyfully titled “NPI Times.” I suggest you get your resumes in order, BCBSTX employees. I’m very good at having my way with archaic business models. Others I have attacked, such as ADA/IDM and Delta Dental, are clearly failing. Coincidence? Perhaps you’d like to tell yourself that when I undermine your support every time you come up for air. Why not send out your sharpest PR specialists? Oh please, would you? Also, equip them with committee-approved talking points that I’ll hang around their necks for a long time.

When I discovered that BCBSTX had a Twitter account, I started asking anonymous employees of BCBSTX about their new NPI number requirement for processing dental claims – even for dentists who have no contractual relationship with the company. But rather than answer a dentist’s questions about their dental policy (incredibly stupid, BCBSTX), the leaders of the command and control company who can no longer command or control their own socks, responded by blocking me from following them. That was irresponsible, childish behavior from one of the largest and most powerful dental insurance companies in the state. Shouldn’t it be important for BCBSTX to respect dentists who must deal with their cumbersome rules?

At a time when managed care dental companies like BCBSTX are lobbying Congress hard to preserve their taxation subsidy, I think it is important for lawmakers to recognize that these huge stakeholders neglect the welfare of those they serve: the principles – dentists and their patients. We are your constituents who count, Congress. Not discount dentistry brokers whose products will not sell in the free market without mandates and taxpayer assistance – simply because they are lousy products.

If BCBSTX had not opened a Facebook account, I would not have opened one myself. I discovered my fat, defenseless opponent when I googlesearched “BCBSTX” the other day. On their first page was the link “What is the NPI number of BCBSTX? – Facebook.” It features a client’s naïve, insignificant question about the NPI number, and it opened the door for my informed, significant one which I copied below, as well as posted on Twitter.

http://www.facebook.com/topic.php?uid=93487018652&topic=8926

By the way, I was disappointed to see that my comment “BCBS-TX Dental Insurance is Rude to everyone,” which I posted on the Medical Executive-Post over three months ago, was no longer on BCBSTX’s first page. It was their third hit for weeks. But since I hadn’t given the comment a bump lately, it has dropped down to the bottom of their second page. Can’t have that! If you don’t mind, please click once or more on the following link and stay there a few minutes. That way, it will push the blunt criticism back up onto BCBSTX’s first page and will once again warn potential clients of BCBSTX’s poor business ethics. If you’re going to be there anyway, why not go ahead and read the sucker? You could find it interesting. Lots of people do.

https://healthcarefinancials.wordpress.com/2009/03/27/bcbs-tx-dental-insurance-is-rude-to-everyone/

As I wrap up this comment, I’ll share with you with the question I left BCBSTX on Facebook almost 6 hours ago concerning their NPI policy. I don’t think Facebook was a good idea for BCBSTX leaders. Sit back and watch me get someone fired today.

Dear BCBSTX:

I would like to point out to readers more information about the NPI number which you are not likely to share. If you have BCBSTX dental insurance, and your dentist does not have an NPI number, BCBSTX will not process your dental claim and the premiums you will have paid to BCBSTX will become unearned profit for BCBSTX.

Is that true, BCBS-TX? Yes or no?

Conclusion

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Filed under: Career Development, Health Insurance, Information Technology, Pruitt's Platform | Tagged: ADA, ADA/IDN, BCBS, BCBSTX, Darrell Pruitt, DDS, Dell, delta dental, dentist, Facebook, Jeff Jarvis, McCarran-Fergusan Act, NPI, NPI Number, twitter | 19 Comments »

Government-Enabled Patient “Bounty Hunters”

Posted on June 30, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Spider Webbing Technology May Trip-Up Miscreant Doctors

By Dr. David Edward Marcinko; MBA CMP™

Under the Health Insurance Portability Accountability Act (HIPAA), the U. S. Department of Health and Human Service (HHS) have operated an “Incentive Program for Fraud and Abuse Information.”

In this program, HHS pays $100 – $1,000 to Medicare recipients who report abuse in the program.

To assist patients in spotting fraud, HHS has published examples of potential fraud, which include:

medical services not provided;
duplicated services or procedures;
more expenses, services, or procedures claimed for than provided (upcoding/billing);
misused Medicare cards and numbers;
medical telemarketing scams; and
no-medical necessity.

Real Health Fraud Exists

There is no question that real fraud exists. The Office of Inspector General of HHS saved American taxpayers a record $32 billion in 2006, according to Inspector General Glenn A. Fine.Savings were achieved through an intensive and continuing crackdown on waste, fraud, and abuse in Medicare and over 300 other HHS programs. To discourage flagrant allegations, regulations require that reported information directly contribute to monetary recovery for activities not already under investigation. For the DRA in 2009, this includes the following:

promoting state False Claims Acts (section 6032);
enhancing the Fair and Accurate Credit Transaction Act, with “red flags” (PL 108-159); see http://www.gpo.gov/fdsys/pkg/PLAW-108publ159/content-detail.html
employee education about false claims recovery (section 6033);
augmenting the Medicaid Integrity Program (section 6034);
enhancing third party recovery (section 6035); and
“mining” medical claims for potential fraud with the help of sophisticated computer technology algorithms – called “spider-webbing” – which locate a common insurance claim denominator and then follow the thread throughout claims review. Indicators of possible fraud include doctors charging more than peers; providers who administer more tests or procedures per patient; providers who conduct medically “unlikely” procedures; providers who bill for more expensive procedures and equipment when there are cheaper options; and patients who travel long distances for treatment.

Assessment

CMS and private companies are able to save far more money by detecting fraud before claims are paid than recovering the money after the fact. And so, a further erosion of patient confidence can be expected as CMS, and private insurers, assume the “bounty hunter” view of healthcare providers.

Conclusion

Of course, your thoughts and comments on this Medical Executive-Post are appreciated. Do you feel like the hunter; or the hunted? Tell us what you think? Do you ever – or never – fear the spider? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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For details about how to report an abuse, see www.usdoj.gov/oig/FOIA/hotline.htm.

Filed under: "Doctors Only", Career Development, Ethics, Health Insurance, iMBA, Inc., Information Technology | Tagged: CMS, david marcinko, DRA, Fair and Accurate Credit Transaction Act, false claims act, fragmented billing, Glen A. Fine, healthcare abuse, healthcare fraud, HIPAA, HSS, Incentive Program for Fraud and Abuse Information, Medicaid Integrity Program, medical claims mining, medicare, medicare cliams mining, spider webbing, unbundled medical billing, unbundling, www.healthcarefinancials.com | 5 Comments »

On Healthcare Intranets and Extranets

Posted on June 26, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

A Primer for Physicians and Medical Executives

By Richard J. Mata; MD, MS, CMP™ [Hon]

According to the “Dictionary of Heath Information and Technology”,

“An intranet is a private network that uses Internet Protocols, network connectivity, and possibly the public telecommunication system to securely share part of an organization’s information or operations with its employees”.

Sometimes the term refers only to the most visible service, the internal website. The same concepts and technologies of the Internet, such as clients and servers running on the Internet protocol suite, are used to build an intranet.

Uses in Healthcare

An intranet is commonly used to provide communication and application services. The advantages of using an intranet in the healthcare setting include the following:

Medical Workforce productivity: Intranets can help employees quickly find and view information and applications relevant to their roles and responsibilities. Via a simple-to-use web browser interface, users can access data held in any database the organization wants to make available, anytime and subject to security provisions — from anywhere, increasing employees’ ability to perform their jobs faster, more accurately, and with confidence that they have the right information.
Time: With intranets, healthcare organizations can make more information available to employees on a “pull” basis (i.e., employees can link to relevant information at a time that suits them) rather than being deluged indiscriminately by e-mails.
Communication: Intranets can serve as powerful tools for communication within a healthcare organization; vertically and horizontally.

Vulnerability and Security Protection

Intranets, like other IT systems, need to be protected by security systems. Any intranet is vulnerable to attack by people intent on destruction or on stealing corporate data. The open nature of the Internet and TCP/IP protocols expose a corporation to attack. Intranets require a variety of security measures, including hardware and software combinations that provide control of traffic; encryption and passwords to validate users; and software tools to prevent and cure viruses, block objectionable sites, and monitor traffic.

Multiple Lines of Defense

The first line of defense is a firewall and these are commonly set up using proxy servers, which allow system administrators to track all traffic coming in and out of an intranet. Another layer of sophistication is added by using a bastion server firewall, configured to withstand and prevent unauthorized access or services. It is typically segmented from the rest of the intranet in its own subnet or perimeter network. In this way, if the server is broken into, the rest of the intranet won’t be compromised.

Authentication Systems

Authentication systems are an important part of any intranet security scheme. They are used to ensure that anyone trying to log into the intranet or any of its resources is the person they claim to be. Authentication systems typically use user names, passwords, fingerprints and iris scans, and various encryption systems.

Protection and Monitoring

Server-based software is used to protect an intranet and its data. Virus-checking software can check every file coming into the intranet to make sure that it is virus-free, and site-blocking software can bar people on the intranet from getting objectionable material. Monitoring software tracks where people have gone and what services they have used, such as HTTP for Web access.

Filtering Systems and Routers

One way of ensuring that the wrong people or erroneous data can’t get into the intranet is to use a filtering router. This is a special kind of router that examines the IP address and header information in every packet coming into the network, and allows in only those packets that have addresses or other data, like e-mail, that the system administrator has decided should be allowed into the intranet. Increasingly, intranets are being used to deliver tools and applications, e.g., collaboration (to facilitate working in groups and for teleconferences) or sophisticated corporate directories, sales and customer relationship management (CRM) tools, project management, etc, to advance productivity. Intranets are also being used as Health 2.0 culture change platforms

Metrics

Intranet traffic, like public-facing website traffic, is better understood by using web metrics software to track overall activity, as well as through surveys of users. Intranet User experience, editorial, and technology teams work together to produce in-house sites. Most commonly, intranets are owned by the communications, HR or IT areas of large healthcare organizations, or some combination of the three.

Assessment

When part of an intranet is made accessible to customers, partners, suppliers, patients, or others outside the healthcare organization – that part becomes part of an extranet.

Conclusion

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Filed under: Career Development, iMBA, Inc., Information Technology, Practice Management, Recommended Books, Sponsors | Tagged: authentication systems, bastion server, blogs, david marcinko, EHRs, EMRs, encryption, extranet, filtering systems, firewall, health 2.0, health information systems, HIT, hope hetico, hospital information systems, HTTP, intranet, metrics, perimeter network, Richard Mata, routers, spam blocker, TCP/IP protocols, virus, virus check, websites, wikis, www.healthcarefinancials.com, www.healthdictionaryseries.com | 1 Comment »

About the MS Office® eMR Project

Posted on June 19, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Programming a Powerful eMR – or – Jumping the Shark?

By Ann Miller; RN, MHA

Recently we communicated with Al Borges MD, founder of the Office eMR Project. He is quite an innovative guy. His passion – eMRs for the physician masses – through an infra-structure already largely in place?

The Problem: You want to use a great eMR but you can’t afford to pay for it.

You have a growing medical office that is completely paper based, and wish to capture the efficiencies of an electronic medical record (eMR) system. But, many eMR systems on the market are complicated, expensive and have been known to actually slow down the typical office workflow. You have used the MS Office® suite of software products in the past and appreciate its power, but you don’t know how to use it to set up a great eMR that perfectly suits your needs.

An Alternative

Alternatively, you can purchase an inexpensive MS Office® based proprietary eMR, but you might wish to write an add-in to incorporate add certain features to this basic, but excellent eMR platform. So, what do [can] you do?

CCHIT Takes a Hit

http://www.emrupdate.com/blogs/emrinterviews/archive/2006/10/09/CCHIT-takes-a-hit-from-Washington_2C00_-D.C.-area-doctor-who-claims-new-certification-group-restrains-free-trade-in-EMR-_2800_Electronic-Medical-Record_2900_-software.aspx

https://healthcarefinancials.wordpress.com/2009/03/02/cchit-is-prejudiced-and-lacks-diversity-%e2%80%93-an-indictment/

A Solution: Open Source Programs

According to Dr. Borges, one may use his web site to get the answers to program your eMR. His site discusses these very issues. It is continuously growing, with a host of free programs, position papers and forum discussions that touch on a wide variety of topics. These include general information on the use of MS Office® in the medical office, programming the various components of MS Office®, and those political topics that affect how we use health information technology [HIT].

Two Program Versions

There are 2 major eMR programs available – the MS Word® eMR Project (MSWP) and the MS Access® eMR Project (MSAP). But, is the Office eMR Project of Alberto truly an interoperable solution – a digital solution – or something else?

Website: http://www.msofficeemrproject.com

Jumping the Shark

Jumping the Shark is a phrase coined by Jon Hein and used by TV critics to denote the point in a show where the plot veers off into absurd story lines in a desperate attempt to attract viewers. Shows that have “jumped the shark” are typically deemed to have passed their peak. On the other hand, is Dr. Borges a Cassandra at his peak … who just happens to be correct?

MSFT Discussion Groups for Al Borges, MD

http://www.microsoft.com/office/community/en-us/default.mspx?query=alborg&dg=&cat=en-us-office&lang=en&cr=US&pt=3a4e9862-cdce-4bdc-8664-91038e3eb1e9&catlist=&dglist=&ptlist=&exp=&sloc=en-us

Making eHRs Illegal?

For example, did you know that the democrats want to make use of non certified eHRs illegal in NJ? The bill allegedly provides specifically as follows:

“On or after January 1, 2011, no person or entity is permitted to sell, offer for sale, give, furnish, or otherwise distribute to any person or entity in this State a health information technology product that has not been certified by CCHIT. A person or entity that violates this provision is liable to a civil penalty of not less than $1,000 for the first violation, not less than $2,500 for the second violation, and $5,000 for the third and each subsequent violation, to be collected pursuant to the “Penalty Enforcement Law of 1999,” P.L.1999, c.274 (C.2A:58-10 et seq.).”

Link: http://www.njleg.state.nj.us/2008/Bills/A4000/3934_I1.HTM

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Is the Office eMR Project a panacea to the eMR conundrum, or a hybrid? What about CCHIT; is it certified – does it have to be? Users and early-adopters, we need your opinions! Has the “shark been jumped” here; or not? Tell us what you think. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Filed under: "Doctors Only", Career Development, Information Technology, Interviews, Op-Editorials, Practice Management, Research & Development | Tagged: Al Borges, Alberto Borges MD, CCHIT, EHRs, EMRs, health information technology, HIT, MS Office eMR Project, MS Office® suite, MSAP, MSWP, Office eMR project, open source eHRs, open source eMRs, PHI | 4 Comments »

Understanding the PHI “Minimum Necessary” Rule

Posted on June 12, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Protected Health Information and HIPAA

By Richard J. Mata; MD, MIS, CMP™ [Hon]

One important concept of the Health Insurance Portability and Accountability Act [HIPAA] is the “minimum necessary” rule, which states the minimum use of Protected Health Information [PHI] to identify a person, such as a social security number, home address, or phone number.

Only the essential elements are to be used in transferring information from the patient record to anyone else that needs this information.

Financial Information Included

This is especially important when financial information is being addressed. Only the minimum codes necessary to determine the cost should be provided to the financial department. No other information should be accessed by that department. Many institutions have systems where a registration or accounting clerk can pull up as much information as a doctor or nurse, but this is now against HIPAA policy and subject to penalties. The “minimum necessary” rule is also changing the way software is set up and vendor access is provided.

Human Resources

Another challenging task is keeping up with the number of people who access PHI, because the privacy regulations allow a patient to receive an accounting of anyone who has accessed their information, both internally (within your hospital, Emerging Healthcare Organization, or medical entity) and externally (such as through your business associates). The patient has the right to know who in the lengthy data chain has seen their PHI. This sets up an audit challenge for the medical organization, especially if the accountability is programmed internally. When other business associates use this PHI without documenting access to a specific patient’s PHI, no one would be accountable for a breach in privacy.

http://www.findbookprices.com/author/Hope_Hetico

One way to track access is through a designated record set, which contains medical or mixed billing records, and any other information that a physician and/or medical practice utilizes for making decisions about a patient. It is up to the hospital, EHO, or healthcare organization to define which set of information comprises “protected health information” and which does not, though logically this should not differ from locale to locale.

Assessment

Overlaps from the privacy regulations that are also addressed in the security regulations are access controls, audit trails, policies on e-mail and fax transmissions, contingency planning, configuration management, entity and personal authentication, and network controls. For more information about the Security Standards final rule; reference the Federal Register.

Conclusion

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Medical Coding and Billing Vocabulary

Posted on June 11, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Basic HIT Nomenclature and HIPAA

[By Richard J. Mata; MD, MIS, CMP™ [Hon]

For the Health Information Technology [HIT] department of a hospital, clinic or medical practice and its coders, the following medical vocabularies are mandated by the Health Insurance Portability and Accountability Act [HIPAA].

Diseases

For diseases: the 9th or 10th International Classification of Diseases (ICD) Clinical Modification should be used. ICD9-CM is maintained by the Centers for Disease Control National Center for Health Statistics, while ICD-10 is maintained by the World Health Organization.

Procedures

For medical procedures: a combination of ICD-9-CM, Current Procedural Terminology maintained by the American Medical Association, the Current Dental Terminology maintained by the American Dental Association, and Healthcare Common Procedure Coding System (HCPCS) maintained by CMS, which is also used for medical devices.

Pharmaceuticals

For drugs: these should be coded according to their National Drug Code classification.

Assessment

“A recent change to Medicare policy made by the Centers for Medicare & Medicaid Services (CMS) helps ensure claims processing isn’t delayed when the only missing information on the CMS-1490S form is the provider or supplier’s National Provider Identifier (NPI).

CMS Transmittal 1747, Change Request 6434, issued May 22, notifies A/B Medicare Administrative Contractors (MAC) and carriers of editorial changes to Medicare policy in Pub. 100-04, Medicare Claims Processing Manual, chapter 1 regarding the monitoring of claims submission violations and the handling of incomplete or invalid claims.

In either case, as stated in the transmittal, “If the beneficiary furnishes all other information but fails to supply the provider or supplier’s NPI, the contractor shall not return the claim but rather look up the provider or supplier’s NPI using the NPI registry.”

http://www.aapc.com/news/index.php/2009/06/missing-npi-no-reason-to-deny-says-cms/

Conclusion

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Filed under: Glossary Terms, Health Insurance, Information Technology, Practice Management, Research & Development | Tagged: ADA, AMA, CDC, CDT, Centers for Disease Control National Center for Health Statistics, CMS, CPT, current dental terminology, current procedural terminology, david marcinko, HCPCS, Healthcare Common Procedure Coding System, HIPAA, hope hetico, ICD-10, ICD-9, international classification of diseases, IT, MAC, medicare, National Drug Code, National Provider Identifier, NPI, Richard Mata, WHO | 2 Comments »

Health Care Uses for Twitter [Suggestions for Micro-Sharing]

Posted on June 9, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Health Care Should be the Leader in MicroSharing – Why isn’t It?

[By Staff Reporters]

According to by Phil Baumann, RN BSN; @ www.PhilBaumann.com

“Twitter may either be the greatest time wasting prank ever played on the internet community – or- it may be the best thing since sliced bread. It’s easy to make the first case if you read the public time-line for a few minutes. It’s a bit harder to make the second, but I’ll do my best to make it. Specifically, I’d like to take a stab at offering 140 health care uses for Twitter. Twitter’s simplicity of design, speed of delivery and ability to connect two or more people around the world provides a powerful means of communication, idea sharing and collaboration. There’s potency in the ability to burst out 140 characters, including a shortened URI. Could this power have any use in healthcare? After all, for example, doctors and nurses.”

Assessment

Read the 23 page white-paper here:

Link: http://blogs.usask.ca/medical_education/archive/2009/02/140_healthcare.html

Conclusion

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Filed under: "Doctors Only", Career Development, Information Technology, Marketing & Advertising, Media Mentions and PR, Practice Management, Research & Development | Tagged: betwittered, healthcare communications, micro-sharing, microsharing, phil baumann, tweet, tweets, twitter, twittering, URI, www.PhilBaumann.com, www.twitter.com | 19 Comments »

Why Coding Professionals?

Posted on June 7, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

More on the NPI, the AAPC, Censorship and Quality Health Care

By Darrell K. Pruitt; DDS

For those who have been following me recently on Twitter (Proots), you know that unlike me, John Hamm has not yet been kicked off of DrBicuspid, and is awaiting a response from Dr. David J. Pettigrew – a dental coding expert with 14 years of experience as Chief Dental Officer for BCBS of New Jersey. I can only shadow the conversation because, as I said, I was kicked off.

Through John Hamm, I sent word to Dr. Pettigrew that he should just shut up and not enter into a discussion about the NPI number. Pettigrew told Johnhamm that I should come onto the DrBicuspid forum and say that in front of everyone. Of course, I am unable to do that because as shameful as it is to my family, I am still banned from posting anything on DrBicuspid.

For real-time developments concerning Dr. Pettigrew’s public defense of the NPI number, it would be better to follow that chunk of drama on Twitter or DrBicuspid. I’ve got other things cooking here. Can you smell it yet?

As you can see, sports fans, I have had Internet contact with a new class of fat, slow-moving healthcare IT stakeholders, and I haven’t been building long-term relationships fortified by good will – if you know what I mean. 14 years of employment at BCBS of New Jersey fails to impress me much.

American Academy of Professional Coders

Those who have studied alphanumeric science have a national organization called the American Academy of Professional Coders [AAPC] which represents business consultants in a growing healthcare niche. Most are employed by providers who are too busy actually performing healthcare to play games with insurance companies for the money owed them. Like SEO professionals who know gimmicks to increase a client’s page rank in relation to competitors, or perhaps a bolus of bad news from a special bastard, professional coders maximize providers’ profits by keeping on top of the ever-changing hoops involved in paying doctors almost all that is owed them following a shorter than average delay.

ICD-10 is Coming

Learning coding is job security these days because in a few years the mandated ICD-10 codes will force even dental offices to hire IT staff, which also cuts down on the nation’s unemployment. I’ve taken a peek at the ICD-10, and it makes the ICD-9 look like simple algebra. I’d stick with well-trained coding professionals. They’ll cost more but you do want to approach making a profit, don’t you?

Of Censorship

I submitted the following stinker to be posted on the AAPC Website. To their credit, it was posted almost immediately. That could be a good sign … OOPS! Several minutes later it went back under moderation. I think someone is having problems with it. You’ll have to read it to understand why. It’s tricky to let go of, yet if it remains posted, it looks like a concession. Some poor slob in the AAPC is in a bad position. I hope you are enjoying this as much as I am.

-Darrell

CMS Transmittal 1747, Change Request 6434, issued May 22, notifies A/B Medicare Administrative Contractors (MAC) and carriers of editorial changes to Medicare policy in Pub. 100-04, Medicare Claims Processing Manual, chapter 1 regarding the monitoring of claims submission violations and the handling of incomplete or invalid claims.

http://www.aapc.com/news/index.php/2009/06/missing-npi-no-reason-to-deny-says-cms/

“How does an NPI number improve patient care?”

By D. Kellus Pruitt DDS – posted on AAPC Website, 6.4.09

I see that nobody from the American Academy of Professional Coders has yet attempted to answer my question. Some visitors to the AAPC Website who have followed the comments to the article “Missing NPI Won’t Delay Processing – CMS” (no byline) may think the lack of an answer is odd – that is if they happen to notice. The novice professional coder who still does not know much about HIPAA could easily assume that since the article itself is almost a week old, the lack of a response to my question is nothing more than the natural fading of interest. At some point, people logically move on to newer posts and other parts of their lives.

But I know a secret.

Based on nothing more than glaring silence from anonymous officials of AAPC, I know that my question of whether the NPI number improves care did not go unnoticed by a few knowledgeable and sharp individuals. They know enough not to touch a transparently trick question. The answer of course is:

The NPI number does nothing to improve patient care (Gasp!)

There’s more. Five years ago informatics experts (coders), promised that the ten digit identification number for providers will speed payments lightning fast. When is the last time you heard that fib? I cannot fault abundant optimism, AAPC, but by now you are surely aware that physicians have had to wait for a year or more for payment because of foul-ups at NPPES. Some have had to take out loans to pay the salaries of coding professionals and other new IT members of their staffs.

Improving Healthcare?

And as far as “improving” patient care? That would be worse than a fib. That would be called a harmful lie that upsets me in a very personal way. I know where it is documented that dental patients have been forced to leave dentists they preferred simply because one-third of the dentists in Texas do not have NPI numbers. BCBSTX requires that their clients only see dentists who have the numbers. Otherwise, the client has to pay their dental bill in full and BCBSTX isn’t even obligated to refund the employer the insurance premium. Yet BCBSTX sales reps tell these employers that their employees can see any Texas dentist they choose.

I’m sorry. Sometimes I ramble.

To keep it fair, I will ask if there is anyone who would like to point out the benefits of the NPI number. Your AAPC members and many others, including enthusiastic newbie coders, are interested in hearing from leaders of the organization. Many careers are built upon the complexities caused by digitalization and informatics. I don’t blame you for the complications. After all, you don’t make the rules – you just get along with them really well. It’s like our unavoidably complicated tax code and accountants. Accountants call themselves professionals. So why the hell shouldn’t you?

The Medical Executive-Post

Let me say that I am grateful that you believe enough in transparency that this comment remains posted. It wouldn’t surprise me if someone briefly considered deleting it until they discovered that it will be on the PennWell forum and probably on the Medical Executive-Post anyway. And of course, we can all see that you chose the honorable thing to do.

NPI Fallacy

The NPI fallacy reminds me of a scene in the Mike Judge movie “Idiocracy,” when a character 500 years in the future named Frito is asked why fields are fruitlessly irrigated with a politically-correct brand of green colored sports drink instead of water. Frito, who got his law degree from Costco, doesn’t even have to suffer minimal thought before he quickly repeats what he’s heard so many times, “’Cause it’s got ‘lectrolytes.”

Grnerod finds it incredible that I don’t have an NPI number. “How on earth are you billing and getting paid without an NPI?”

I told him (?) that I don’t work if I don’t get paid. Call me an old school radical.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. What are your feelings on the NPI situation? Does it really improve health care, or not? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Filed under: Glossary Terms, Health Economics, Health Insurance, Information Technology, Op-Editorials, Practice Worth | Tagged: A/B Medicare Administrative Contractors (MAC), AAPC, ADA, AMA, American Academy of Professional Coders, BCBS New Jersey, BCBS New York, CMS, CMS Transmittal 1747 Change Request 6434, CMS-1490S, CPT codes, Darrell Pruitt, david marcinko, Dr. David J. Pettigrew, DrBicuspid, ICD-10, ICD-9, John Hamm, medical billers, medical coders, Medicare Claims Processing Manual, National Provider Identifier, NPI, NPI Number, Proots, Pub. 100-04 | Leave a comment »

Obama, HIT and Transparency in Government

Posted on June 5, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Enhancing Transparency in Government using the Internet

By Darrell K. Pruitt; DDS

I recently came across news that could possibly be the first tangible step in the inevitable demise of traditional lobbyist representation that we have known and endured all our lives. True to what the man promised in the fall of 2007, Barack H. Obama is ready to show the nation that he intends to decentralize power by enhancing transparency in government using the Internet.

Decentralization

Decentralization naturally scares entrenched, oppressive leaders inside and outside government who in the best of all worlds, shouldn’t be entrusted with power in the first place. It is my opinion that we are witnessing a huge Presidential step in the inevitable progress of the Internet-powered social revolution many have predicted for a decade or more. According to the unprecedented lobbying rules, virtually anything anyone says to public officials about the Recovery Act and Stimulus package must be immediately posted on the Internet (if it is not there already). No kidding. For example, I discovered this news in an article on the White House blog, posted by Jesse Lee on Friday, Its title is “Update on Recovery Act Lobbying Rules: New Limits on Special Interest Influence” (copied below).

Here is a line from the article: “Following OMB’s review, the Administration has decided to make a number of changes to the rules that we think make them even tougher on special interests and more focused on merits-based decision making.”

I am hopeful that Obama is sincere in his effort to steer our legislative body to make decisions based on merits rather than undocumented conversations funded by special interests. If he succeeds, one class of losers will be managed care stakeholders like Delta Dental who prefer to spend healthcare dollars to lobby congress rather than work things out with dentists who have to deal with their calculated lies. A perfect example of Delta’s stupidity is documented in “National insurer asks legislators to keep dental benefits in mind in health care reform” featuring Delta’s shy PR rep, Janis Oshensky.

http://ifawebnews.com/2009/04/01/national-insurer-asks-legislators-to-keep-dental-benefits-in-mind-in-health-care-reform

Insurance and Financial Advisor Website

The fact that Delta would pay for such a disingenuous PR piece on the Insurance & Financial Advisor Website shows how out of touch Oshensky is. It was posted appropriately enough on April 1. Two months later, I still cannot figure out the purpose of the ad. Just who was the vice president of dental relations and public policy for DDPA trying to impress? Her insurance buddies? Was this Janis Oshensky’s swell idea, or did a committee come up with the stinker? I don’t think we’ll ever know. Also, among the losers to transparency will be healthcare IT stakeholders with lousy goods to move. Rather than compete with each other, they prefer lobbying for mandated sales of worthless, but nevertheless CCHIT-certified products. Fair sales without the help of billions of stimulus dollars are impossible because doctors don’t want eMRs for unanticipated reasons of intelligence.

Healthcare IT Business Leaders

Recognized leaders of big healthcare IT businesses, such as Glen Tullman, the CEO of Allscripts, won’t like handing over political empowerment one bit. Did you know that Tullman and Obama are long-time Chicago buddies? I think the new rules mean Americans will finally have immediate access to their discussions about HIT. Sweet; I think I could learn to like Obama. I bet Tullman keeps his mouth shut. That’s sweet as well. If this news is as significant as it appears to be, I’m surprised it hasn’t attracted more attention by now. While nobody knows yet how Obama’s plan to post transcripts of oral communications with government officials is going to ultimately affect the way professional organizations are represented in Washington (or if it in the end changes anything at all), I’m pretty sure that what I have been reading carefully has the potential to turn the government over to those who can create content independent of committees, talking points and traditional hierarchy. I interpret Obama’s rules as the manifestation of what Thomas Friedman (“The World is Flat”) long ago called individual empowerment.

Got a beef? How are your writing skills these days? How effective is your social network?

This is good. The new restriction on oral communications with government officials for both registered and non-registered lobbyists (everyone in the nation) is terrible news for organizations which depend on store-bought secretive representation. On the other hand, it’s wonderful news for English majors, speech writers and special bastards with no shame.

ADA Lobbyists

I would never attempt to persuade you to take on my personal issues as your own, but please roll this development over in your mind and decide for yourself if the information I’m sharing might become an advantage for dental patients in the nation if dentists are mobilized for a more democratic form of representation long before the insurance industry can react. And that shouldn’t be too hard. Committees move oh so slowly, including ADA committees. If I am correct, if we work unconventionally, dentistry could be way ahead of the curve by preparing for independent written representation using informal social networks and Internet blogs. No planning or financing is needed. Face it, the money the ADA has paid to lobbyists starting a few years ago was wasted, and there is no way they can help the organization now. Dump them.

PR Assistance

Here is some powerful PR help I offer for free that cannot be purchased at any price, anywhere: If a dentist posts something that parallels my goals, on any blog, I will easily boost the exposure of the article more effectively than any SEO genius in the nation. I’ve proven so many times how I can do this by merely mentioning someone’s name. And I can help again, and again. All I have to do is discover someone who has confidence in good ideas for protecting our patients from harm. Put it out there and sit back. I’ll do the rest.

Assessment

I wonder if Obama knew anything about special bastards and unconventional PR when he chose transparency as a goal for his administration. Maybe I can teach him a thing or two. I have faith that if one’s goals are noble, nothing can hurt you in the land of the free. Come on out. The air is fine.

http://www.whitehouse.gov/blog/Update-on-Recovery-Act-Lobbying-Rules-New-Limits-on-Special-Interest-Influence/

FRIDAY, MAY 29TH, 2009 AT 5:35 PM

Update on Recovery Act Lobbying Rules: New Limits on Special Interest Influence

Posted by Jesse Lee

THE BRIEFING ROOM • THE BLOG

Another update from Norm Eisen, special counsel to the president for ethics and government reform, in the spirit of transparency as always:

I am writing with an update on the President’s March 20, 2009 Memorandum on Ensuring Responsible Spending of Recovery Act Funds. Section 3 of the Memorandum required all oral communications between federally registered lobbyists and government officials concerning Recovery Act policy to be disclosed on the Internet; barred registered lobbyists from having oral communications with government officials about specific Recovery Act projects or applications and instead required those communications to be in writing; and also required those written communications to be posted on the Internet. That Memorandum instructed the Office of Management and Budget (OMB) to review the initial 60 days of implementation of the stimulus lobbying restrictions, to evaluate the data, and to recommend modifications.

Following OMB’s review, the Administration has decided to make a number of changes to the rules that we think make them even tougher on special interests and more focused on merits-based decision making.

First, we will expand the restriction on oral communications to cover all persons, not just federally registered lobbyists. For the first time, we will reach contacts not only by registered lobbyists but also by unregistered ones, as well as anyone else exerting influence on the process. We concluded this was necessary under the unique circumstances of the stimulus program.

Second, we will focus the restriction on oral communications to target the scenario where concerns about merit-based decision-making are greatest –after competitive grant applications are submitted and before awards are made. Once such applications are on file, the competition should be strictly on the merits. To that end, comments (unless initiated by an agency official) must be in writing and will be posted on the Internet for every American to see.

Third, we will continue to require immediate internet disclosure of all other communications with registered lobbyists. If registered lobbyists have conversations or meetings before an application is filed, a form must be completed and posted to each agency’s website documenting the contact.

OMB will be consulting with agencies, outside experts and others about these principles and will publish detailed guidance, but we wanted to update interested parties on the outcome of the initial review. We consulted very broadly both within and outside of government (including as reflected in previous posts on the White House blog) and we are grateful to all those who participated in the process.

Conclusion

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Filed under: Alerts Sign-Up, Career Development, Ethics, Health Law & Policy, Information Technology, Op-Editorials, Research & Development | Tagged: ADA, Allscripts, American Dental Association, “Update on Recovery Act Lobbying Rules: New Limits on Special Interest Influence”, CCHIT, DDPA, delta dental, EHRs, EMRs, Glen Tullman, HIMMS, HIT, Insurance & Financial Advisor, IT, Janis Oshensky, Jesse Lee, lobbyists, Norm Eisen, obama, OMB | 11 Comments »

My Favorite Health 2.0 Experience from the Exam Room

Posted on June 4, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

HIT From the Trenches

By Hayward Zwerling; MD

I was in the exam room talking to a patient, who I am treating for hyperthyroidism. The patient complained of profound fatigue, of several months duration. It was unclear if the problem was being addressed by the PCP. While talking to the patient, I reviewed all his labs which were in ComChart EMR. There was nothing obviously wrong.

A True Story – July 07, 2006

From within the exam room, and while still talking to the patient, I connected to my hospital’s computer and download all his labs which were less than 1 year old. I then had ComChart file the labs into his ComChart chart. I then had ComChart EMR create a chart of all his CBCs by clicking the “Chart … CBC” button in the labs. It was obvious that his hematocrit had dropped precipitously sometime between January and March.

The PC computer I was using had Skype installed (a free program which allows you to make free telephone calls from your computer.) I also have a headset attached to this computer, which I use with Dragon NaturalSpeech Medical. While still in the exam room, and from within ComChart EMR, I clicked the “PCP” button in the patient’s Progress Note and a dialog box popped up and asked “Do you want to go to the Dr. XXX’s Addresses file?” I selected “yes.” I then clicked on the label “private,” which is in front of the physician’s “private” phone number. ComChart opened Skype and connected the call. I spoke with the PCP and I arranged for the patient to see the PCP the following day.

I then click the “orders” button and selected my “anemia work-up” panel. This created a lab order slip which included all the necessary blood tests. I choose the option “Send copy of results to … PCP” and then clicked the button “Fax order slip” to lab.

Contemporaneous Progress Notes

Finally, in front of the patient, I dictated a Progress Note, using Dragon NaturalSpeech 8 Medical. The resultant Progress Note included the chart of the patient’s CBCs. I then selected the PCP as the recipient, and clicked the button “Create queued fax.” In my office, I have one computer which continually sends out the “queued faxes” as soon as they are created. Thus, the PCP had received a copy of the Progress Note and the lab had received the lab order slip even before the patient left my exam room. The entire process occurred within a few minutes.

Assessment

Needless to say, that patient was impressed that my office was able to use technology in order to efficiently advance their healthcare. And, the fact that it all happened in front of the patient, seem to reassure the patient and de-mistify the healthcare delivery process.

Conclusion

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Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Information Technology, Practice Management | Tagged: CBC, ComChart, ComChart eMR, CPC, Dragon Naturally Speaking, EHRs, EMRs, hayward zwerling MD, health 2.0, PC, Skype, SMAC | 2 Comments »

On Incestuous eHR Relationships

Posted on June 2, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

More on HIMMS and CCHIT

By Darrell Pruitt; DDS

Ann and ME-P Friends

I want to share with you this article from Kaiser that just popped up.

http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=58548

The Healthcare Information and Management Systems Society (HIMSS), an organization founded by healthcare IT technology vendors and other stakeholders, is the parent organization of the Certification Commission for Healthcare Information Technology (CCHIT). In fact, CCHIT is presently managed by HIMSS’s former chief medical officer, Mark Leavitt. That’s not all. This Kaiser article points out that until recently, Leavitt was being paid by HIMSS while working for CCHIT. As some of us already openly suspect, the public-private powerhouse called CCHIT certainly sports the architecture of world-class conflict of interest in the Victorian style of the late 19^th century.

The Washington Post Expose’

Just yesterday, Robert O’Harrow Jr., writing for the Washington Post, said documents show HIMSS asked the Obama Administration to require that any electronic health record equipment receiving stimulus funding be certified by CCHIT – the stakeholders’ bastard progeny.

http://www.washingtonpost.com/wp-dyn/content/article/2009/05/20/AR2009052003600.html

Well, O’Harrow actually didn’t use the words, “bastard progeny.”

CCHIT Steering HIMSS

HIMSS naturally thinks keeping CCHIT as the steering organization of healthcare IT is a really swell idea, and maintains that ‘meaningful use” of their goods is very, very important in rewarding stimulus money. Yet, as significant as the buzz-word sounds, it looks to me like “meaningful use” will be better described as “clicking for cash.”

Leavitt Brushes Off Criticism

The Kaiser article says that Leavitt brushes off the critics of CCHIT as would-be vendors who are angry because they failed certification; incredible mind, that man!

Assessment

Even before I read this article, and the accompanying “In related news” blurb about National Coordinator for Health IT David Blumenthal, I have seen a few things that make me suspect that Blumenthal and CCHIT leaders, specifically Glen Tullman from Allscripts, are probably already viciously, but secretly butting heads. I interpret this real-time history to show that soon, Blumenthal will either hang Leavitt and CCHIT over “meaningful use’ or he will resign in frustration.

But, what do I know? I’m a dentist, not a plumber.

Conclusion

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Filed under: Alerts Sign-Up, Breaking News, Career Development, Ethics, Information Technology, Op-Editorials | Tagged: Allscripts, CCHIT, Certification Commission for Healthcare Information Technology, David Blumenthal, EHRs, EMRs, Glen Tullman, Healthcare Information and Management Systems Society, HIMMS, Kaiser, Mark Leavitt, National Coordinator for Health IT, Robert O' Harrow Jr | 5 Comments »

Interview with Jack Levy of Securebill, Inc

Posted on June 1, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

President – Securebill, Inc

What: An Interview and Special Report Exclusively Prepared for the ME-P
Who: Mr. Jack Levy, CISSP [President – Securebill, Inc]
Topic: Physician Selection of eHRs
Reporter: Amaury Cifuentes; CFP®
Where: Internet Ether

Although skeptics of eHRs abound, President Barack H. Obama’s signing of the American Recovery and Reinvestment Act [ARRA] of 2009 has created a massive push for their implementation. The Act provides $19.2 billion, including $17.2 billion for financial incentives to be administered by Medicare and Medicaid. This assistance of up to $40 to $65 thousand per eligible physician, and up to $11 million per hospital, begins in 2011.

Link: https://medicalexecutivepost.com/wp-content/uploads/2009/05/jack-levy-interview.pdf

Conclusion

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

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Sponsors Welcomed

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Filed under: Breaking News, Career Development, Information Technology, Interviews, Practice Management | Tagged: Amaury Cifuentes, American Recovery and Reinvestment Act, ARRA, CISSP, EHRs, electronic medical records, EMRs, HITECH, Jack Levy, Medicaid, medicare, obama, Securebill | 1 Comment »

Feds Propose Educational Website on ePHRs

Posted on May 31, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Site Aimed at Consumers

[By Staff Reporters]

As reported by Mary Mosquera on May 22 2009, the Office of the National Coordinator for Health Information Technology (ONCHIT) just proposed developing a Web site for consumers. The site is to contain facts about electronic-personal health record systems and their privacy policies. It aims to help consumers and patients make informed decisions.

http://govhealthit.com/articles/2009/05/22/feds-propose-phr-website.aspx?s=GHIT_260509

Assessment

The Department of Health and Human Services [DHHS] Agency information collection request, for a 30-days public comment period, is also located here.

http://edocket.access.gpo.gov/2009/E9-12023.htm

Conclusion

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FINANCE:Financial Planning for Physicians and Advisors
INSURANCE:Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Breaking News, Career Development, Information Technology, Military Medicine, Practice Management | Tagged: CCHIT, DHHS, EHRs, electronic health records, electronic medical records, EMRs, ePHRs, ePRs, medical records, Office of the National Coordinator for Health Information Technology, ONHIT | 5 Comments »

ME-P Now on Technorati Finance and Wikio Health

Posted on May 30, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

What is Technorati Authority and Wikio for Blogs?

By Staff Reporters

On Friday May 4th, 2007, Technorati.com was updated to include the Technorati Authority for blogs and listed on their Blog page and in search results. This update changed the earlier references of “N blogs link here” and “X links from Y blogs” with the single Technorati Authority number. On the blog page, it also shows the Technorati Rank.

Technorati Authority

Technnorati Authority [TA] is the number of blogs linking to a website, like this ME-P, in the last six months. The higher the number, the more Technorati Authority we have. It is important to note that Technorati measures the number of blogs, rather than the number of links. So, if a blog links to the ME-P many times, it still only counts as +1 toward our authority. Of course, new links mean the +1 will last another 180 days.

Technorati Calculations

Technorati Rank is calculated based on how far we are from the top. The blog with the highest Technorati Authority is the #1 ranked blog. The smaller our Technorati Rank, the closer we are to the top. Since at the lower end of the scale many blogs will have the same Technorati Authority, they will share the same Technorati Rank.

Technorati Rankings

The Technorati Top 100 shows the most popular 100 blogs based on Technorati Authority. The #1 ranked blog is the blog forum with the most other distinct blogs linking to it in the last 6 months. If our blog’s rank is, say 305,316, this indicates that there are 305,315 blog ranks separating our blog from the #1 position.

Help Increase our ME-P Rankings

The best way to increase our ME-P Technorati Authority is to write and submit cogent posts and fascinating comments that are interesting to other like-minded ME-P bloggers; so they’ll link to us. Why? Swagger, and free-labor journalistic entrepreneurship, of course. Linking to source material when you blog is also a great way to engage in conversation and help others find what you find interesting. Finally, since we want to let readers see our Technorati Authority on this blog, we have just installed the TA [and Wikio] widgets for all our ME-P readers and subscribers [June 2009]

Link: http://www.wikio.com/subscribe?url=http%3A%2F%2Ffeeds.feedburner.com%2FHealthcareFinancialsthePostForcxos.

Assessment

Remember, authority is determined by the number of unique blogs indexed by Technorati that have linked to us in the past 180 days. Thus, as links from blogs age out of this window and new links are added, our ME-P authority may rise, fall, or stay the same over time. Also, if the same blog links to us many times in the past 180 days, it only counts once towards our authority though it does renew the age of link. Additionally, the link must appear in our blog reactions to be applied to our authority. If the links are not in our blog reactions, please check to see if the blogs and/or your post with the links are in Technorati. If they are not, then encourage blog owners to ping Technorati; or better yet to claim their blogs in Technorati (gives the blog higher priority). And so, blogs are submitted for review and then indexed by Technorati for their blogs and posts.

Raising ME-P Authority

Your thoughts and comments on this Medical Executive-Post are appreciated to raise our Technorati Authority.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

http://www.BusinessofMedicalPractice.com

***

Filed under: Breaking News, Experts Invited, Information Technology, Media Mentions and PR | Tagged: blogs, david marcinko, ME-P, medical executive post, Technorati, Technoraty Authority, wikio, wikio health | Leave a comment »

About the ASTER Pilot Project

Posted on May 29, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Improving the Reporting of Adverse Events

By Staff Reporters

According to its website, ‘ASTER’ stands for “ADE Spontaneous Triggered Event Reporting”. The ASTER study was conceived as a proof-of-concept project for a new model of gathering and reporting spontaneous adverse drug events (ADEs).

A Collaborative Project

ASTER is a collaboration of the following organizations and individuals:

Brigham and Women’s Hospital (Dr. David Bates is sponsor, Dr. Jeffrey Linder is Lead Investigator)
Partners Healthcare – use of the Longitudinal Medical Record
CDISC (an international standards group)
CRIX International (a public/private not-for-profit organization)
Pfizer Incorporated

Assessment

ASTER will implement automated ADE collection in an ambulatory clinic electronic health record (eHR). It employs a flexible standard for data collection known as “Retrieve Form for Data” (RFD) from CDISC and Integrating the Healthcare Enterprise (IHE), and will use CRIX International to host the application. The application allows direct downloading of data from the EHR and will forward the report to the FDA in the proper formats for electronic reporting of individual case safety reports (ICSRs).

http://www.asterstudy.com

www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/Article/data/05MAY2009/0905HHN_Inbox_Medication&domain=HHNMAG

Conclusion

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Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Breaking News, Career Development, Drugs and Pharma, Information Technology, Practice Management | Tagged: ADE Spontaneous Triggered Event Reporting, ADEs, adverse drug events, adverse drug reactions, ASTER, CDISC, CRIX, Dr. David Bates, Dr. Jeffrey Linder, EHRs, EMRs, FDA, ICSRs, IHE, longitudinal medical records, Partners Healthcare, Pfizer | 2 Comments »

Global Health CIO Congratulations

Posted on May 29, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Medical Technologists That Stand Out in the Crowd

By Staff Reporters

The May 25, 2009 issue of InformationWeek listed the top Fifty Global Chief Information Officers [CIOs] from around the world and profiled them by the strategic contributions made to their respective companies.

Healthcare IT Leaders

Curiously, we noted these health care, medical and pharmaceutical related CIOs on the report:

Chen Jinxiong – Fuzhou General Hospital
Jody Davids – Cardinal Health
Dan Drawbaugh – University of Pittsburgh Medical Center
Feng Taichuan – Xian-Janssen Pharmaceutical
Michael Heim – Eli Lilly
Daniel Lebeau – GlaxoSmithKline Biologicals

Assessment

Full profiles may be accessed at: www.informationweek.com/globalcio50

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Feel free to congratulate these folks for a job well done, and review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Sponsors Welcomed

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Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Breaking News, Career Development, Drugs and Pharma, Information Technology | 2 Comments »

On the Patient Friendly Google Health Initiative

Posted on May 28, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Data Integrity and Health 2.0 Accuracy Concerns Linger

[By Staff Reporters]

According to its’ website, and mission statement, Google Health aims to put patients in charge of their digital health information. It’s safe, secure, and free.

Triple Play of Benefits

Google Health purports to:

Organize health information all in one place.
Gather medical records from doctors, hospitals, and pharmacies.
Share information securely with family members doctors and caregivers, etc.

Google says members are always in control of how data is used. It will not sell information. Members decide what to share, and what to keep private.

Link: privacy policy

Blogsite

Google health was launched in the spring of 2008. Since then, it even maintains its own blog-site, which stated on 3/4/09.

“We continue to learn a tremendous amount since launching Google Health in the spring of 2008. We’re listening to feedback from users every day about their needs, and one issue we hear regularly is that people want help coordinating their care and the care of loved ones. They want the ability to share their medical records and personal health information with trusted family members, friends, and doctors in their care network”

Link: http://googleblog.blogspot.com/2009/03/google-health-helping-you-better.html

Good thing too!

A Cautionary Tale

However, privacy advocates worry about the vast amount of data that Google is redacting. Growing consumer market clout means the early-adopter patient who cares about digital records, and eHRs, may have fewer choices in the future. And, for medical professionals, what does this say about CCHIT, Allscripts and the Military, etc; or, the emerging Wal-Mart eMR initiative for doctors?

Assessment

For example, when one now [in]famous patient named Dave deBronkart – a tech-savvy kidney cancer survivor – tried to transfer his medical records from Beth Israel Deaconess Medical Center to Google Health, he was stunned at what he found.

Read this Link: http://www.boston.com/news/nation/washington/articles/2009/04/13/electronic_health_records_raise_doubt

Is MSN’s Health Vault any better?

Channel Surfing the ME-P

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Breaking News, Ethics, Health Law & Policy, Industry Indignation Index, Information Technology, Military Medicine, Research & Development | Tagged: Allscripts, Beth Israel Deaconess, CCHIT, Dave deBronkart, digital medical records, EHRs, EMRs, Glen Tullman, google, Google Health, health 2.0, Health Vault, HIPAA, medical records, Wal-Mart | 22 Comments »

Employers and eDocAmerica

Posted on May 26, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

An Emerging Health 2.0 Benefits Program

By Staff Reporters

eDocAmerica’s mission is to improve health by providing direct, online access to medical services, making it much more convenient to get the information for employees to take better care of themselves.

Services

Services enable employees to provide better self care, to lead to a healthier life, and to visit a physician only when necessary. Medical problems can often be managed with the tools available on eDocAmerica’s website. Services include medical information from board certified physicians, and educational material about the medical conditions of employees and family members. Physician responses are authoritative and are made within 24 hours from the time of the request, with most responses arriving in three to four hours. Problems that require a more rapid response should be managed by a visit to a personal physician or an emergency facility.

MD Online

MD Online LLC [dba eDocAmerica] is a fully funded, private company. eDocAmerica has a ‘no advertising policy’ and therefore does not host or receive funding from advertising from the display of commercial content. It is an HONcode compliant website. (www.hon.ch)

Benefits

eDocAmerica provides an innovative and effective Health 2.0 employee benefit program that purports to:

Increase employee satisfaction and morale
Decrease absenteeism
Save money on health care costs
Improve employees’ health
Provide online access to board certified physicians.

Assessment

eDocAmerica allows employees or members to have access to board certified, experienced physicians to consult with them about health care. eDocAmerica physicians provide personal advice, suggest treatment alternatives, use links to websites, provide patient information from other sources, or refer employees to their specialists – all from the workplace desktop computer or from home. The cost of eDocAmerica for a year for one employee is less than one primary care visit.

More Info
email: info@edocamerica.com and phone: 1-866-525-eDoc (3362)

Conclusion

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Filed under: Alerts Sign-Up, Career Development, Financial Planning, Health Insurance, Information Technology, Insurance Matters, Quality Initiatives, Research & Development | Tagged: eDocAmerica, employee benefits, health 2.0, health 2.0 employee benefits, MD Online, online healthcare, online medical services | 1 Comment »

American Recovery and Reinvestment Act Primer for Physicians

Posted on May 20, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Free ARRA Webinar Series

By Staff Reporters

Are you ready to maximize American Recovery and Reinvestment Act (ARRA) opportunities in your medical practice?

The Webinar Series

This webinar series is designed to support physician practices as they prepare for a new health care environment. As new information becomes available, experts and health care leaders representing diverse sectors will review key components of ARRA and offer insights on the impact to the physician community.

Topic: Stimulus 101: Basics of the Health Information Technology Provisions

When: Thursday, May 21, 12:00 PM CST

Presenters:

Glen Tullman, Chief Executive Officer – Allscripts
Margaret Garikes, Director of Federal Affairs – AMA

Assessment

Plus, hear from practices using eHR systems and how they made the transition.

Registration: https://cc.readytalk.com/cc/schedule/display.do?udc=1ip8sqjax7frw

Conclusion

And so, your thoughts and comments on this Medical Executive-Post, and webinar series, are appreciated; especially from seminar participants. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Filed under: "Doctors Only", Breaking News, Career Development, Information Technology, Op-Editorials, Practice Management, Research & Development, Videos | Tagged: Allscripts, AMA, ARRA, EHRs, EMRs, Glen Tullman, HIT, HITECH, IT, Margaret Gariks, webinar, www.healthcarefinancials.com, www.healthdictionaryseries.com | 6 Comments »

Health Information Technology Security and Encryption

Posted on May 18, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Understanding the Risks of eMRs and Internet Connectivity

[By Carol S. Miller; RN, MBA]

E-mails, PDA data, and Internet connectivity, unless encrypted, can be read by anyone. Therefore, if these items are not encrypted, physicians should be careful of what they say and how they say it, especially when discussing any patient information with other providers, vendors, or managed care organizations. In addition, just because you deleted e-mail from the system does not mean that you have deleted it from the server or from the computers that maintain copies of your server’s data. HIPAA regulations set forth the criteria in electronically transferring patient related data via the Internet.

Secure and Encrypt Messages and Health Information

If you want secure messages, an encryption program should be used. If the message is intercepted the text will be scrambled to anyone other than your intended recipient. Most physicians feel encryption is too time consuming; however, programs such as Pretty Good Privacy at www.pgp.com provides an easy and nearly seamless integration into e-mail and operating systems, encrypting the sensitive files but still allowing ease of communication. PCP software developed by MIT and endorsed by HIPAA, uses privacy and strong authentication. Only the intended recipient can read the data. If files were intercepted, they would be completely unreadable. Other software programs are available in the marketplace that will work using a private key – similar to a password. Tell the program the name of the file you want to encrypt and the private key, and the program uses a mathematical algorithm to encrypt the file. For reference material on various encryption and security software programs, search the web under “encryption” or go to one of the following sites: www.zixit.com, www.cisco.com, www.aspencrypt.com, or www.verisgn.com.

Assessment

In addition to encryption, the office needs a good anti-virus program that is designed to detect and prevent viruses, such as Norton Anti Virus at www.symantec.com and McAfee VirusScan at www.mcafee.com

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Book Reviews, Career Development, iMBA, Information Technology, Practice Management, Recommended Books, Sponsors | Tagged: carol s. miller, david marcinko, EHRs, EMRs, health 2.0, health data encryption, health information security, healthcare IT, HIPAA, hope hetico, internet connectivity, PDAs, www.healthdictionaryseries.com, www.medicalbusinessadvisors.com | 6 Comments »

On Medical and Other Patient-Centric Specialty Homes

Posted on May 15, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

New Guidelines Released

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

According to Chris Silva, AMA News on May, 12 2009, new medical home guidelines have just been released.

Physician Input

Four physician organizations have developed new guidelines for medical home projects to ensure consistency and help define how a patient-centered home model should look. The 16 guidelines include recommendations on who should collaborate on the projects, how they should choose practices to participate, what type of support should be provided to practices, how practices should be reimbursed, and what each project should do to analyze and report results.

Link: http://www.ama-assn.org/amednews/2009/05/11/gvse0512.htm

Assessment

Physician groups hope clarity and consistency will lead to broader acceptance of the programs. But, what about mental health homes or dental homes; how about podiatry or optometric homes, etc? What about patient mobility?

Is this concept even viable given our increasingly mobile society? Or, is this philosophy fixed in the last century; especially in light of the Obama Administration’s HIT, and eHR initiatives? Was the fluid health 2.0 culture even considered? What are we missing?

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE:Financial Planning for Physicians and Advisors
INSURANCE:Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: "Doctors Only", Breaking News, Career Development, iMBA, Inc., Information Technology, Op-Editorials, Practice Management, Quality Initiatives, Research & Development, Sponsors | Tagged: Chris Silva, david marcinko, dental homes, EHRs, HIT, medical homes, obama, patient centric medical homes | 15 Comments »

On HIT Cost Savings

Posted on May 14, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Real or Imagined Solutions

According to David M. Cutler, of the Center for American Progress Fund [CAPF] on May 11, 2009, health care will be the major challenge to the federal budget in coming decades. Rising health costs will account for nearly all of the expected increase in government spending relative to gross domestic product [GDP].

Healthcare Costs and GDP

Health care currently accounts for 16 percent of domestic GDP, and that share is forecast to nearly double in the next quarter century. Spending money on health care is not bad, but wasting money is very bad.

Link: http://www.americanprogressaction.org/issues/2009/05/health_modernization.htmlHIT

HIT to the Rescue

But, $600 billion might be saved over the next ten years, and $9 trillion saved over the next 25 years, if HIT initiatives are used; says the CAPF.

Assessment

Estimates suggest that a third or more of medical spending—perhaps $700 billion per year—is not known to be worth the cost. Wasting hundreds of billions of dollars on inefficient health care is a luxury the country cannot afford.

Conclusion

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Filed under: Career Development, Health Economics, iMBA, Inc., Information Technology, Practice Management | Tagged: CAPF, Center American Progress Fund, David Cutler, federal budget, GDP, health costs, health technology, healthcare economics, HIT, medical spending | 3 Comments »

About HealthCareTownHall.com

Posted on May 12, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

The Great eHR Debates

By Staff Writers

Milliman hosts this blog to encourage an informed dialogue about healthcare reform. Healthcare is complicated, and there is no single, silver-bullet answer to the question of “How do we best improve the current system?” But thoughtful discussions will help move reform in the right direction and mend the fractured system.

Assessment

A shout-out of thanks, for this link, goes to Jeremy Engdahl Johnson of Healthcare Town Hall.

Link: http://www.healthcaretownhall.com/

Conclusion

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Setting Up a Medical Practice Web Site

Posted on May 11, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Establishing Healthcare Presence on the Internet

[By Carol S. Miller; RN, MBA]

Many physician practices are interested in creating their own Web sites to provide information about their practice to patients, the community, peers and other individuals; market their practice specialty; provide ease of access to medical inquiries or scheduling appointments; and provide links to other health-related sites.

There are “easy-step” programs available in the marketplace, such as the IBM home page. Web sites, like www.webdeveloper.com can assist your practice with a tutorial and step-by-step process in creating and developing an initial site.

Templates

Many programs include already established page templates. As part of the process, the Web site can be connected to an online service provider; however, many practices have considered using a Web-hosting company, such as www.hostdepot.com. With this process, the practice will create its own domain name, the name given to a host computer on the Internet. With this name in place, it will be easier for your patients to remember, easier to provide linkages to other sites, and you won’t have to change your Web site’s URL (Uniform Resource Locator or Web address) each time you move your Web site.

Starting Point

A good place to start is www.budgetweb.com or www.e-businessexpress.com. Other reference sites are www.microsoft.com/frontpage, www.register.com to register and renew domain names, and www.verizon.net. As an example of cost for Verizon, there is a set up fee of $50-$100 for setting up the web site, a monthly service fee from $30-$100 depends on the options selected and web design fees vary by page or hours and from several hundred dollars to over $1000.

Assessment

If the medical practice is interested in developing a more sophisticated end product, it is recommended that a Web-page designer work with the practice to design a Web site conducive to your expectations.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE:Financial Planning for Physicians and Advisors
INSURANCE:Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Book Reviews, iMBA, Inc., Information Technology, Sponsors | Tagged: carol s. miller, david marcinko, EMRs, healthcare IT, healthcare websites, IBM, medical practice websites, medical professionals, physicians, template websites | Leave a comment »

Physician Use of the Internet

Posted on May 10, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

The Slow Evolution of a Healthcare Tool

[By Carol S. Miller; RN, MBA]

The Internet is a constantly evolving service that continues to grow at an exponential rate, especially in physician practices. Primarily, the Internet is used as a means to electronically and expeditiously transfer data via e-mail as well as obtain information from a variety of sites. Initially, in the physician’s office, the primary use was e-mail communications with peers, hospitals and others. Next providers linked to hospitals and managed care organizations to obtain more direct connectivity for clinical information and benefit coverage. Today physicians are finding other beneficial avenues to expand their utilization of the Internet. Several examples include:

Direct e-mail inquiries from the patient to the physician.
Patient educational newsletters and links to other healthcare educational web sites.
Continuing medical education (CME).
Chat room consultations, conferences or presentations with other providers.
Nurse to patient e-mail connectivity.
Immediate data on lab results with alerts for abnormal high or low values.
CPOEs (Computerized Purchase Order Entry Systems).
Radiology images.
EMR (Electronic Medical Records).
Monitoring of patients blood sugars or EKGs via the Internet.
Appointment scheduling on-line by patients.
Patient appointment reminders via the Internet.
Secure physician portals such as Medicity, located at www.medicity.com, which allows access to pertinent and prioritized data from a wide range of sources and vendors to include, labs, imaging centers, hospitals, payers and others.
HIPAA compliant Application Service Providers (ASP) for dictation, recording, routing and speech recognition and transcription services, such as Speech Machines at http://www.speechmachines.com.

Access Management

Besides the value to the patient and the physician, the physician can utilize his or her Internet connection with software firms such as NextGen to automate the registration, scheduling, eligibility verification, billing and “clean” claims processing via innovative Web-base solutions in real-time scenarios. All the physician’s office needs is a PC, a standard Internet browser, and a connection to the Internet to take advantage of this service.

Assessment

These resources and more, via the Internet super highway, enable physicians to have quicker and easier access to clinical information and improve productivity. Furthermore, these tools will quickly assist providers with accurate and timely medical decision making, thus improving patient care and outcomes.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

http://www.BusinessofMedicalPractice.com

***

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ADSL – DSL Primer for Physicians

Posted on May 8, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Asynchronous Data Subscriber Line versus Digital Subscriber Loop

By Carol S. Miller; RN, MBA

Asynchronous Data Subscriber Lines

ADSL is a very fast digital line provided by the telephone company. If available in your area, the ADSL provides fast connections, but generally not as fast as cable. There are various choices, beginning around 256 kbps (about five to six times the speed of a fast modem) going up to 7 Mbps. Prices begin around $60 per month (including Internet service). There is also a set-up charge and a card needs to be inserted in your computer.

Digital Subscriber Lines

DSL is a high-speed direct line that can be 20-100 times faster in communication over the modem, depending on the type selected. Prices for the DSL begin at approximately $30-$40 per month and that includes Internet access. In addition, there is a set-up charge and a network card will need to be installed into the computer. Office workstations can usually share DSL circuits over their existing local area network (LAN).

Internet Connection

To connect with the Internet, as a rule of thumb, the faster the better; therefore, the office should have at least 56 kbps. DSL normally runs over the same line as a basic telephone voice circuit and provides Internet access from speeds of 384 kbps all the way up to 1.54 mbps (megabits per second). The advantage of this configuration is you not only have high-speed access to the Internet, your telephone is still free to make and receive calls at the same time.

Integrated Services Digital Network

A digital telephone line that allows voice and data to be transmitted on the same line in a digital format – instead of analog – and at a relatively high speed, usually around 64 to 128 kbps. When reviewing this service, make sure the ISP has an ISDN connection. If not, you will be charge more by both the telephone company and the ISP. Prices for the ISDN average around $300 plus, with an extra fee to install the telephone line and a monthly service charge of $25 to $100 plus to maintain.

Wireless Network (WiFi – 802.11b)

The biggest change to happen to computers in the last ten years has undoubtedly been the Internet. Close on its heels in importance may just be the adoption of the wireless network access. Wireless Fidelity, or Wi-Fi, is now cost effective and available at the computer store. It is no longer necessary to re-wire buildings with Category 5 wire to provide LAN connectivity and resource sharing to multiple computers. Wi-Fi, or IEE standard 802.11b, enables small offices to connect up to four computers to a single network for less than the cost of a single computer. This means the days of multiple analog lines to offer Internet access to every computer, or a printer on every desktop, are going away. Now a single cable modem or DSL line and a centralized printer can service four users. This can save a small business hundreds of dollars a year.

www.HealthDictionarySeries.com

Limited Connectivity

For limited connectivity, computer stores are stocked with wireless vendor products that are cost effective, easy to install, and very robust that will push even the most cautious computer user to take the leap to wireless computing. Not only does it make the initial cost to install a network cheaper than it has ever been before, it eliminates the cost to remodel or move computers within a building since instead of requiring data wiring at each proposed desktop all you need now is an electrical outlet to power the PC itself.

Satellite

This is a more modern device. In the past, satellite connections were at 400K bps or fourteen times faster than the average modem. As an example, a 2MB file would be downloaded in 30-40 seconds. Benefits of the satellite connection are: The connection is always on; it is reliable; there is a secure connection; office can have multiple e-mail addresses; the web space is free; and there is tech support coverage nationwide. Costs include around $300 for the equipment, $150 plus to install the equipment, and around $30 to $50 per month for service. Web site reference is satcast.com (DirecWay Satellite Dish).

Conclusion

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Filed under: Book Reviews, Glossary Terms, Health Law & Policy, iMBA, Inc., Information Technology, Practice Management, Recommended Books, Sponsors | Tagged: ADSL, asynchronous data subscriber line, cable modem, carol s. miller, david marcinko, digital subscriber line, digital subscriber loop, DSL, EHRs, EMRs, hope hetico, IEE, internet connection, ISDN, LAN, moodem, WAN, WiFi, WiMax, wireless network, www.healthcarefinancials.com, www.healthdictionaryseries.com | Leave a comment »

Application Service Provider Primer for Physicians

Posted on May 7, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Understanding ASPs

By Carol S. Miller; RN, MBA

An Application Service Provider (ASP) enables healthcare organizations to run complex software programs or applications on remote servers that can be accessed from numerous sites and by numerous devices. By installing and maintaining central, instead of on-site services, ASPs reduce the complexity, time, resources, hardware requirements, technical support, cost of installing and distributing upgraded software (done by ASP at its host site), and cost involved in application management. In addition, ASPs provide the physician a means of low cost entry to new applications in a very short timeframe. Upgrades are quickly deployed and healthcare organizations or medical offices can experience affordable and secure business critical applications. Most ASP services are billed on a per use basis or monthly annual fee. An example of an ASP is NextGen, an Internet based enterprise and a real-time practice management system that includes an electronic medical record, appointment scheduling, connectivity with hand-held solutions and patient indexes.

Reverse ASPs in Healthcare

Healthblocks (www.healthblocks.com) coined the term “reverse ASP” to signify that as an ASP, it provides unique solutions through the Healthblocks eSite, tailored to the situations and circumstances that face healthcare organizations and care givers on a daily basis. More formally, a reverse ASP deploys through portals, hosts and manages access to medical applications that offices, in a single, seamless manner, can view a patient’s clinical information. The applications are delivered over networks on a subscription basis and the reverse ASP remotely manages the packaged application over a network. The following benefits are achieved in this model:

Hardware/software located on recipient’s facility can connect disparate facilities
User names/passwords are located on-site with extensive integration with legacy systems
Existing clinical data remains on-site without danger of lost data
Connectivity to ASP solutions is not dependent upon an ISP

Assessment

A reverse ASP model provides physicians, nurses, allied healthcare providers and related personnel with rapid access to confidential clinical patient information. It can also benefit and help extend the reach and usefulness of third-party e-health solutions in a cost-effective manner.

www.HealthDictionarySeries.com

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated? Who can update the above for modernity?

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ISP Primer for Physicians

Posted on May 5, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Understanding Basic Access and Connectivity

By Carol S. Miller; RN, MBA

To connect with an Internet service, the medical office will need a computer, modem, telephone line and software. The modem, either external via a connection or internal via a built-in or slot card, takes the digital signals from your computer and converts them to analog signals that your phone line uses. As a rule of thumb, the faster the better; therefore, the office should have at least a 56 bps or use a DSL line.

Accessing the Internet

To access the Internet, the office must obtain an Internet Service Provider (ISP) such as America Online (AOL), Earthlink, ATT Worldnet, Microsoft Network Premiere (MSN), Hot Link, or others. The cost varies on the plan selected but usually averages in the range of $10 to $25 per month. In selecting an ISP, several guidelines need to be considered:

The major online services often make it very easy to connect to the Internet, but may be more expensive;
Many low-priced ISPs may have customer service that matches their prices;
In selecting the ISP, make sure the provider has a toll-free or local support telephone line;
For a nationwide directory list of ISP providers, go to the Internet site of www.isp.com.

Besides the POTS (plain old telephone service), the physician may wish to have a faster connection to the Internet. Several options are available.

Cable Modems

Cable connection is very fast, providing a lot of bandwidth (the amount of information that can be sent through a particular communication channel). As an example, in the time it takes to transfer a half page across a 56K connection, the cable connection can transfer over 25 pages. As is suggested by the name, the local cable TV provider or community antennae TV (CATV) deliver this service.

www.HealthDictionarySeries.com

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated? Who can update the above for modernity?

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Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Filed under: Book Reviews, Career Development, Glossary Terms, Information Technology, Practice Management, Sponsors | Tagged: AOL, bandwidth, cable modems, carol s. miller, CATV, david marcinko, DSL, EHRs, EMRs, hope hetico, internet connectivity, ISPs, MSN, POTS | 1 Comment »

Reviewing Medical PDAs

Posted on May 3, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Physician Use Growing Slowly

By Carol S. Miller; RN, MBA

Handheld personal digital assistants (PDAs), such as Palm Pilot M130, 500 or 515, Sony Clie, Visor Prism or Pro, Psion, RIM Blackberry, Zaurus, iPhone, Zune and other comparable PDA OS platforms, have revolutionized the communication world this past decade. PDAs and their future counterparts are becoming the catalyst for physicians to use information technology, are becoming the intro for physicians into the world of the electronic medical record software, and becoming the virtual office tool, enabling providers to communicate away from the desktop as well as away from his office practice. The reasons for increased utilization with physicians are portability, pocket-size, provides easy access to information at point of care and regardless of location, improves practice efficiency and workflow, improves drug related decisions and decreases adverse drug events.

PDA Components

The common uses of PDAs by physician practices are:

Personal applications such as scheduling, telephone directories, dictionary, “to-do lists” and others
Drug databases
Clinic suite that ties into the hospital information system
Charge and procedure capture
Communications, from provider to provider, provider to hospital, provider to office, and vice versa

Palm Operating System

Palm OS still represents the standard in handheld computing, assisting individuals to manage and access information at any time, at any location. Handhelds are easy to use. Physicians are using the Palm OS and/or compatible PDAs to access their office schedules, receive downloads of clinical information on their patients, and enter clinical services and charges when performing services at remote locations.

PDA Selection

In selecting not only the PDA but also the software, the physician needs to answer the following questions:

What would you like to use the PDA for – clinical reference data, patient information, non-clinical applications, personal data, etc.?
What information do you need to know about the patient that the PDA can simplify?
What is the connection route between the hospital, managed care, or lab and your practice? In other words, how do you get access to the data?
What are your price considerations?
Do you need a color or black and white screen?
What is the system support and warranty?
How do you plan to connect to the office or hospital?
Do you want to go wireless or obtain information via a telephone connection?
Do you plan to render care outside of your office practice, such as in the home, a clinic, hospital setting, etc? If so, what would you like included on the PDA that would improve communication with the office and save time at point-of-service in documentation?

HIPAA

HIPAA regulations do not specifically address the specific term PDA, but the regulations do include guidelines for protecting patient information and transmission of this data that can impact the use of PDAs. Physicians are utilizing handheld digital assistants whether they contain clinical information; or just resource data, may be or not are password protected, and may or may not be officially supported by hospitals or clinics. Providers as they prepare for future applications and usage of PDAs involving patient information must understand the scope of the new HIPAA regulations as it impacts on patient data collected, stored or transmitted. Any application involving patient identifiable data must be HIPAA compliant. The key issues are how to protect the patient information stored on the device, i.e., if lost or stolen, and second how to protect patient information transmitted during a synchronization or wireless transaction. Probably the most vulnerable aspect is the loss rate with recent studies indicating at least 30%.

Security

Most providers using PDAs for patient data utilize a user ID or password level of security. To maintain security, the provider should be required to re-enter their user ID or password every time they enter the application. Likewise, each PDA should have a “time out” feature, requiring a provider to re-enter his ID or password again. This feature will not prevent individuals with technical skills from accessing this information – the only mechanism is encryption.

Synchronization versus Wireless Applications

1. Synchronization transfers information from the enterprise database to the PDA, i.e., hospital lab or x-ray results, patient demographics, consultative notes, and others. It is important that the hospital or hospital system authorize and approve the physician for using and transmitting this information and in turn, the provider authenticates and validates his agreement with the hospital before data is transmitted. In addition for protection, an audit trail of who synchronized and what data was transmitted should be maintained by the hospital system.

2. Wireless providers have immediate real time access to patient data; however this process of transmission is more vulnerable than synchronization. Wireless solutions can utilize a public or private network. HIPAA require encryption for the transmission of data over the public networks – Encryption is optional for others. Sharing data from a wireless over the Internet represents potential security issues; however, more and more technical firms and providers are using a wireless VPN that allows PDA users to connect securely from remote locations just as laptop users do today.

Other Issues

The other issues are who owns the PDA. If the provider does, he or she should be responsible for the security; however if the hospital does, the hospital should be responsible. More current applications of Palm OS will include built-in modems for easier wireless communication, improved secure transactions, and ability of greater resolution for graphics, and other Web-based services. In addition, current and future applications will include refined voice dictation. As an example, MDEverywhere’s package called Everynote allows the provider to digitally record notes and in turn links with MDEverywhere’s coded patient encounter.

The Blackberry

A very versatile product is the Blackberry. It has web browsing capabilities, embedded wireless modem and can (1) write, send receive and respond to messages right from the unit, (2) access web information, (3) has nationwide coverage with no roaming fees, (4) has voice mail message capabilities, and (5) can be the size of a pager or PDA. The next feature with Blackberry will be its text messages to cell telephones. New units start around $150-$300 with monthly service charges of $20-$50 depending on the plan. The wireless Internet connection can be accomplished through Go.Web.

Assessment

The typical cost for a PDA averages between $300 and $600 – depending on color or black and white – plus the cost of additional software and accessories. For wireless connectivity, the physician will need to connect with a communication partner. Reference sites for PDAs are: www.handheldmed.com (for clinical, reviews, and news), www.pdamd.com (PDA resources), www.freewarepalm.com (free software programs), www.palmpilot.com, www.handspring.com. The active shopper can refer to www.zdnet.com or www.palmblvd.com

Conclusion

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Filed under: Book Reviews, Career Development, Health Law & Policy, iMBA, Inc., Information Technology, Practice Management, Sponsors | Tagged: apple iphone, blackberry, carol s. miller, david marcinko, EHRs, EMRs, handheldmed.com, handspring.com, Health I.T., HIPAA, hope hetico, iPhone, MDE, OS, Palm, Palm OS, PDA, personal digital assistants, telemedicine, Zune | Leave a comment »

Red Flag Rules in Dentistry

Posted on May 1, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Mayday for Identity Theft Provisions 2009

By Darrell K. Pruitt; DDS

On October 22, 2008, the FTC announced that it would delay the enforcement of the Red Flags Rule for healthcare providers for six months – until May 1, 2009. A handful of attentive dentists, as well as ADA Chief Legal Counsel, Tamara Kempf, released a sigh of relief. Ms. Kempf immediately went to work to persuade the FTC to delay enforcement “indefinitely.”

The FTC Delay

Four days later, Kempf caught the mood of the few who were paying attention in her quote for an article on DentalCompare.com:

“We are very pleased that the Federal Trade Commission has postponed for six months its implementation of the ‘Red Flags Rules.’”

http://www.dentalcompare.com/news.asp?newsid=250078

The DentalCompare article continues:

“If the FTC persists in its position that dentists are covered by the rule as creditors, the ADA will make available a sample compliance plan or program well in advance of the new enforcement date. Dentists will have sufficient time to consult with their personal attorneys and to put an appropriate identity theft prevention program into place, according to the ADA’s Legal Division.”

The ADA Legal Division

Did the ADA’s Legal Division follow through with its promise? If information about the Red Flags Rule is posted on the ADA News Online Website early tomorrow morning, is a 24 day warning considered by the ADA to be “well in advance”? (Emphasis mine) As reassuring as Kempf’s words sounded five months ago, it can be argued that the ADA’s intentions were misrepresented to DentalCompare. I checked the ADA Online Website and found nothing at all about preparation for the Red Flags Rule – at least not yet.

http://www.ada.org/prof/resources/pubs/adanews/index.asp

ADA Archives

When I searched the ADA archives for “Red Flags Rule,” I was provided seven links to the topic, but none included “a sample compliance plan or a program.” Three of the links are irrelevant, three are to articles about the delay of the FTC enforcement, and one is a link to a hopeful letter dated November 24, 2008 and addressed to William E. Kovacic, Chairman of the Federal Trade Commission. In other words, I found nothing that will help dentists become FTC compliant well ahead of time.

HIPAA

If the ADA’s help in preparing members for the 1996 HIPAA Rule is any indication of the help members can expect with Red Flags Rule, it will take the ADA at least 13 years to start on the Red Flags. The leaders of the otherwise conservative ADA seem to have bet a huge chunk of membership trust that Kempf and the Legal Affairs department would succeed in delaying Red Flags enforcement indefinitely, and that the Department of Dental Informatics would not have to admit that contrary to what they led members to believe, computers in dental offices are rapidly becoming too dangerous and too expensive for the profession. For many dentists, pegboards, carbon paper and ledger cards are looking better and better. You can forget about paperless practices. What happened, ADA?

The groveling November 24 letter to the FTC chairman that was signed by Kempf and cc’d to ADA President Dr. Johns S. Findley and President-elect Dr. Ronald L. Tankersley, officially begs for forgiveness and appeals for bureaucratic mercy to allow dentists to be excluded from becoming Red Flags-covered entities.

http://www.ada.org/prof/advocacy/let_081124_redflags.pdf

Since the fines for non-compliance of both HIPAA and the Red Flags Rule are obscene, and since the leaders of the ADA continue to fail to inform members what they should do to prepare for unannounced inspections from either HHS or the FTC, I will once again do the Department of Dental Informatics job for them, and let readers in on the secret.

An Economic Threat

If you wish to continue to accept assignment from insurance companies, and/or otherwise extend credit to your patients, the FTC recently posted a helpful pdf document titled “Fighting Fraud with the Red Flags Rule – A How to Guide for Business.”

http://www.ftc.gov/bcp/edu/pubs/business/idtheft/bus23.pdf

Dentists have become the nation’s unpaid fraud inspectors. And if a dentist’s practice is computerized, the more will be expected, or rather, demanded of the dentist, by law.

Here is a brief description of dentists’ Red Flags obligations lifted from the FTC document:

An Overview

The Red Flags Rule sets out how certain businesses and organizations must develop, implement, and administer their Identity Theft Prevention Programs. Your Program must include four basic elements, which together create a framework to address the threat of identity theft:

First: Your Program must include reasonable policies and procedures to identify the “red flags” of identity theft you may run across in the day-to-day operation of your business. Red flags are suspicious patterns or practices, or specific activities that indicate the possibility of identity theft. For example, if a customer has to provide some form of identification to open an account with your company, an ID that looks like it might be fake would be a “red flag” for your business.

Second: Your Program must be designed to detect the red flags you’ve identified. For example, if you’ve identified fake IDs as a red flag, you must have procedures in place to detect possible fake, forged, or altered identification.

Third: Your Program must spell out appropriate actions you’ll take when you detect red flags.

Fourth: Because identity theft is an ever-changing threat, you must address how you will re-evaluate your Program periodically to reflect new risks from this crime.

Note: More “red-flag” information may be obtained from the 2 volume, 1,200 pages, premium print guide: Healthcare Organizations [Financial Management Strategies].

www.HealthcareFinancials.com

Assessment

Since my business office still uses the pegboard, and no patients’ identifiers are on any computer, my official Red Flags policy is simple:

“Staff; if you notice anything unusual in relation to our patients’ accounts; or if you are handed an unusual-looking drivers license, notify me immediately”.

-The Management

My official notice will be fastened with thumb tacks to my wall of safety posters by May 1, 2008, and I will be in full compliance with not only HIPAA, but the Red Flags Rule as well. If the government continues its reckless, heavy-handed, one-size-fits-all laws, it won’t be long before I’ll be able to further undercut the fees charged by all computerized dental offices, and still make more profit. I say bring out the Department of Agriculture.

Conclusion

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Filed under: Alerts Sign-Up, Book Reviews, Breaking News, Career Development, Health Law & Policy, Healthcare Finance, iMBA, Inc., Information Technology, Managed Care, Practice Management, Professional Liability, Risk Management | Tagged: accounting ledger cards, ADA, AMA, American Dental Association, carbon paper, DDI, DentalCompare.com, Department of Dental Informatics, Dr. Ronald L. Tankersley, fake IDs, FTC, HIPAA, HSS, ID, identity theft prevention, Johns S. Findley, pegboards, red flag rules, Tamara Kempf, William E. Kovacic | 32 Comments »

Networks Basics for Medical Professionals

Posted on May 1, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Defining WANs and LANs

By Carol S. Miller; RN, MBA

Depending on whether the practice is housed in one or multiple-office locations and there is a need to connect multiple computers, either a local area network (LAN) or wide are network (WAN) should be part of the package consideration.

The LAN

The LAN is a computer network that covers only a small area (often a single office or building). The advantage of a LAN (besides connecting several computers to a network system) is the ability to configure one printer for multiple stations. The same may be said for sharing administrative, clinical, financial and operational data in real-time manner to support smooth office function.

The WAN

The WAN provides the ability to link data on one network for multiple office site locations.

www.HealthDictionarySeries.com

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated? Who can update this post for modernity?

Link: https://healthcarefinancials.wordpress.com/2009/03/13/rip-retail-financial-services-industry/

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Filed under: Book Reviews, Career Development, Glossary Terms, iMBA, Inc., Information Technology, Practice Management, Recommended Books, Sponsors | Tagged: carol s. miller, david marcinko, hope hetico, LANs, medical computer networks, WANs, www.healthdictionaryseries.com | Leave a comment »

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