Practice Fusion Blog

Is there a Doctor in the Mouse?

Prompted by increasingly permissive reimbursement policies, digital office visits--in which patients and physicians use computers to manage clinical issues that traditionally necessitate an office visit--are growing faster than biceps on steroids.

Big Insurers from Aetna to WellPoint are experimenting with such programs, which are a time-savers for everyone and less expensive than a schlep to the doctor’s.

“If…there is payment for it, we will see many more primary-care physicians doing it,” Ted Epperly told the Wall Street Journal. The president of the American Academy of Family Physicians said that at the moment, about 3% of his organization’s members offer digital office visits.

Physicians agree that the new format is best reserved for simple stuff; colds and flu, urinary infections, back pain and sleep disturbances for example.

Even in such instances, some offer the option only to patients they know, mostly as a hedge against malpractice.

And no physician in her right mind would go this route for symptoms that could spell trouble, like chest pain--any kind of pain really--or abdominal symptoms, which are notoriously difficult to diagnose without a physical exam. 

The field is still in shake-out mode, with many formats for the interaction being tried in many venues across the country. The simplest approach is using secure, HIPAA-compliant email . Practice Fusion will support this activity as part of its Patient Health Record scheduled for release in Q1, 2010.

In another format, patients must complete symptom-specific algorithms in advance of the actual interaction. The snazziest approach involves live, online visits using Web video, chat or a phone conversation routed for privacy purposes through a secure computer system.

In a joint experiment of the latter approach, American Well and the Hawaii Medical Service Association combined to offer such services to enrollees, who pay a $10 co-pay for the privilege. 

For non-insured online visits, the going rate around the country seems to be about $20-35 a steal when compared to the cost of the old-fashioned schlep.

Glenn Laffel, MD, PhD, Sr. VP Clinical Affairs

Big O Bobs, Weaves on Public Plan

During Tuesday’s press frolic, the Big O put some mustard on his pitch for a public option, dismissing as “not logical” suggestions that a government plan would sink Big Insurance faster than the Titanic.

He followed quickly with a favorite refrain, which is that good, old-fashioned competition from a public plan would be an “important tool to discipline insurance companies.”

Then, in a denouement worthy of at least runner up at a Harvard Law Debate Club, he triple-dog-dared anyone to come up with a better plan that met his 2 etched-in-stone requirements. “Reform has to control costs and it has to provide relief to people who don’t have health insurance or are underinsured,” he said.

Big Insurance, destined in this match to play Smokin’ Joe to the Big O’s Ali, released a wild haymaker of its own 2 hours before the Big O even showed up.

“We do not believe it is possible to create a government plan that could operate on a level playing field,” quoth Karen Ignagni, president of America’s Health Insurance Plans, and Scott Serota, president of the Blue Cross and Blue Shield Association in an open letter to the Senate.

“Regardless of how it is initially structured, a government plan would use its built-in advantages to take over the health insurance market,” the letter continued.

No doubt the Big O smirked when he read that.

Meanwhile, Kent Conrad, the intrepid Senator from North Dakota has created a stir with his suggestion that nonprofit consumer-owned cooperatives could be an alternative to the government plan. He foresees the Feds forking over $3-4 billion to jumpstart the co-ops, after which time they would sink or swim on premiums and investment income, just like Big Insurance.

The Big O knows he can live with this or any approach that covers most everybody without breaking the bank, but this day he was on offense.

“If private insurers say that the marketplace provides the best quality health care, if they tell us that they’re offering a good deal, then why is it that the government — which they say can’t run anything — suddenly is going to drive them out of business?” Obama asked.

Dr. Spock himself couldn’t have asked a more logical question.

Glenn Laffel, MD, PhD, SVP Clinical Affairs

The emergence of a national health IT policy

The American Recovery and Reinvestment Act (ARRA) creates  the framework for a national health IT policy. Such a policy has never previously existed. In order to develop such a policy, a new set of federal advisory committees has been convened – the Health IT Policy Committee has now met and has reported its findings to date here.

 

In a short amount of time, the Health IT Policy Committee has developed a very positive framework that helps IT developers (such as Practice Fusion) gear their efforts in a consistently meaningful direction. The HIT policy started with an “ultimate vision to enable significant and measurable improvements in population health through a transformed health care delivery system.” Adapted from the National Priorities Partnership, several overall goals have been identified: (1) improve quality, safety and efficiency; (2) engage patients and their families; (3) improve care coordination; (4) improve population and public health, and reduce disparities; and (5) ensure privacy and security protection. This overall vision is described in a “meaningful use preamble” document.

 

For each of these Health Outcomes Policy Priorities, a series of Care Goals have been defined in a “meaningful use matrix.” And for each of these Care Goals, a series of Objectives for 2011, 2103 and 2015 have been proposed, as well as Measures associated with these Objectives by which to determine “meaningful use.”

 

Actual detailed Certification Criteria are currently being defined, and will be derived from the Objectives. Practice Fusion has been engaged in this process and has submitted commentary to the committee.

 

The traditional certification criteria for EHRs has come from CCHIT, a non-profit agency that grew out of an EHR vendor trade organization (HIMSS), but was spun-off as an independent agency. CCHIT had been designated as the sole certification pathway for EHRs prior to ARRA. However, the certification criteria developed by CCHIT since 2006 were developed in the absence of a guiding national health IT policy. Such criteria could be characterized as being more product-centric than results-oriented.

 

The newly created Meaningful Use Objectives, from which new certification criteria will be derived, commendably is more focused on results than any particular “functionality” characteristics of the software. It is as yet unclear how the certification process will be carried out, and what role CCHIT will play in this process, but what is becoming clear is this: in order for EHRs to be examples of “enabling technology” that will truly transform healthcare, “what counts are results.” Practice Fusion remains committed to engaging this process and developing products that will satisfy all the “meaningful use” criteria and truly help enable a transformed healthcare system.

 

Robert Rowley, MD

Chief Medical Officer

Practice Fusion, Inc.

Follow us on Twitter: #practicefusion

New Feature Update

We've been busy at work adding new features and we wanted to take a moment to share with you some of the highlights as well as keep you informed about our progress.

Click on the link below to launch a video summary of our new features:

 

 

Don't forget - We have free, live, online training everyday.  To access our free training program simply log in to your account and click on the link in the top right corner that says 'Sign up for Training'.  You can attend as many trainings as you like.  We also have on demand video tutorials available inside the application that are there for your convenience.

 

To get the most out of Practice Fusion be sure to upload all of your patients demographic information.  It's free and once you upload the file in the proper format we will post all of the patients to your account within 24 hours.

The Practice Fusion community and template library are growing!

We've been experiencing some great growth lately.  Here's a list of the types of practices currently served by Practice Fusion:

Allergy and immunology

Dermatology

Family practice

Internal medicine (general)

Cardiology

Endocrinology

General practice

Gastroenterology

Geriatric medicine

Hematology

Infectious disease

Nephrology

Oncology

Pulmonology

Rheumatology

Sports medicine

Orthopedics

Obstetrics / Gynecology

Ophthalmology

Pediatrics (general)

Physical medicine and rehab

Neurology

Psychiatry

Surgery

Urology

We also have a large and growing library of templates for new practices to use (you can still always build your own):

Behavioral health (psychiatry and psychology)
Cardiovascular / metabolic
Dermatology
ENT (ear/nose/throat)
Everyone (these are the wellness templates)
Gastroenterology
Hematology and oncology
Musculoskeletal (works for ortho, physical medicine & rehab)
Obstetrics / gynecology
Office procedures (works for FP, surgery)
Ophthalmology
Pediatrics
Respiratory (pulmonology)
Urology
Vascular surgery

It only takes a few minutes to get signed up and start using Practice Fusion.  Get started today at www.practicefusion.com

Top 10 reasons to choose Practice Fusion

1. It's Free - Practice Fusion is the only 100% Free EHR system on the market today. 
2. $44,000 - In a very short time Physicians will become eligible to receive up to $44,000 from the Federal Government for adopting and showing meaningful use of a qualified EHR system.
3. Hosted - Being web-based and a hosted "Software as a Service" click here to learn more, Practice Fusion relieves you of the cost and burden of having and maintaining your own servers, network, security, etc.  All you need are internet connected PC's and you're ready to go!
4. Data Security - All data in the Practice Fusion system belongs to you.  We can export the information for you at any time.  Practice Fusion uses the latest technology to keep your data safe and secure.  To learn more about the security benefits built into Practice Fusion please click here.
5. Simplicity - Our engineers have made Practice Fusion one of the easiest to use EHR packages in the industry.  Log into your Practice Fusion account and see for yourself.  See something that needs improvement?  Send us an email and we'll incorporate your feedback.  At Practice Fusion we're committed to being the best EHR system on the market.
6. Community - From the moment you start using Practice Fusion you'll be able use and share templates with other Physicians in your area of expertise.  Our plan, philosophy and product are built around the idea that the community matters.  We're planning on leveraging the community to help you and your practice grow and connect with important resources when you need them.
7. Training - When you join the Practice Fusion community we make a commitment to fully train you and your staff.  We offer free, live trainings for as long as you use our product.  Whether you have a new employee, need to take a refresher course or just want to get caught up on the latest features, we're always there to help out.
8. ePrescribe and electronic labs - We've been listening to your feedback and we've heard you loud and clear: ePrescribe and Electronic Lab results are on the way!
9. Data imports - Do you have a spreadsheet with all your patient data?  Maybe you have an old legacy system with your patient information and/or you have it all stored in your billing software?  If you have demographic data on your patients then starting and using Practice Fusion just got a whole lot easier.  We import the data for you and get you setup within 24 hours so that you can hit the ground running.
10.  A lifetime of free upgrades - We add new features to our product every week.  Most of our work in improving the system comes directly from our user community.  You'll never have to pay more with Practice Fusion to use the latest software!

To log into your account click here.

 

If you have misplaced you login information please email support@practicefusion.com and we will be happy to assist you.

 

 Thank you!

The Practice Fusion Support Team
support@practicefusion.com

“Meaningful use” and what it means to physicians

The Obama administration’s massive stimulus package (known as ARRA) contains a section pertaining to the adoption of electronic health records (known as HITECH), and earmarks substantial money (up to $44K per physician over the next 5 years) for physicians who can demonstrate “meaningful use of certified EHRs.” Defining what exactly is meant by “meaningful use” has been the focus of intensive debate as the newly-created government bodies charged with oversight of this have begun deliberation. The exact definition of “meaningful use” should be hammered out by the end of 2009, with incentives beginning to become available to physicians in the subsequent years.

 

“Certification” has similarly been a subject of much debate. Traditionally, CCHIT has been the sole certifying body for EHRs, emerging as a non-profit agency spun off from a government-industry collaborative. Many have assumed that CCHIT will remain as the going-forward certification body, but others have questioned this and propose that alternatives to certification are appropriate. They argue that, besides the $30K certification price tag, CCHIT developed its criteria in an era when large, self-contained client/server EHR systems were emerging, and that such criteria lose relevance in a web-based, distributed, cloud-oriented environment – such as the one that Practice Fusion has emerged in. CCHIT wants to modernize its criteria, but it may lag behind technological innovation.

 

Regardless of how certification will emerge, it is clear that “certified EHR” and “meaningful use” will be closely linked. In order to qualify for “meaningful use,” an EHR should be able to do the following:

1.     Electronic prescribing, both out-bound e-prescribing of new, de novo prescriptions, as well as responding to prescription refill requests originated by pharmacies

2.     Achieve interoperability, meaning that summary data (diagnoses, medications, allergies, etc.) can be easily exchanged with others using different EHRs. There is a standard type of document, called a Continuity of Care Document (CCD) which needs to be able to be created and exported, as well as imported.

3.     Generate quality reporting and metrics. The criteria set has yet to be determined, but is likely to be either the HEDIS set of metrics (used by insurers in the private domain) or the larger PQRI set (used by Medicare, and which encompasses the HEDIS criteria plus many more)

4.     Point of care decision support. This will be a technology that evolves, starting with simple things like prompting for wellness and chronic-disease management prompts, but evolving into presenting physicians with evidence-based guidelines for the diagnosis at-hand.

5.     Routine, secure, electronic communications between patients and caregivers. This can include prevention and screening reminders, and numerous other ways of supporting patients in their own management of their own health.

 

The specifics of all of this, of course, will be hammered out in the debate process this year. Practice Fusion is keeping a very close eye on all of this, and is rapidly building features in each of these categories. Our goal is to offer physicians a robust EHR that is not only free to use, but also will qualify everyone for “meaningful use” as this definition becomes clearer. Whether CCHIT remains the sole certifying channel, or whether it becomes one of several avenues towards certification, Practice Fusion intends to achieve “certification” as ultimately is defined by HITECH.

 

Robert Rowley, MD

Chief Medical Officer

Practice Fusion, Inc.

Follow us on Twitter: #practicefusion

The Practice Fusion Help Center

This week we are excited to announce the release of the Practice Fusion Help Center, a brand new feature whose purpose is to provide an easy way to access context sensitive help.

How do I access the Help Center?

When you log into Practice Fusion you will notice a new vertical button on the right hand side of the application. It is orange and labeled ‘Help Center’. Clicking on it will launch the Help Center for the section you are currently looking at.

Note: main components are numbered in the screen shot, please read on to find out more about each one.

Feature Highlights:

1. Choose a topic or section you would like to explore, FAQ's for that section will appear on the screen.
2. Video tutorials are listed for your chosen topic (#2 above). Clicking on a tutorial will launch a new internet browser tab or window. The video should begin playing automatically.
3. All feedback and questions can now be directed to Practice Fusion Support through the Help Center. Simply bring up the Help Center and click ‘Send us Feedback’. 
4. Last but not least, users can now sign up for training through the Help Center. Simply click ‘Schedule a Training’ and choose a date and time that works for you.

Note:  if you have a pop-up blocker running, it may appear that clicking on a video does nothing. Please add PracticeFusion.com to your accepted pop-up list to avoid this problem.

The videos come complete with sound, so please make sure you have headphones handy, or speakers plugged in.

Thanks!

Practice Fusion Support Team

New features released!

Here's a summary of the new features we released yesterday:

A new and improved help center.  We'll go into more detail in our next post.  It's the yellow button on each screen:

Now you can toggle back and forth from US to the Metric system in charts:

We've simplified the process of starting a new Patient Note:

and then...

We've added a new mechanism for searching patients and locating duplicates:

Lastly, when you log in, we've added a feature to help keep you informed about any site downtime for maintenance.

We hope you enjoy the new features.  As always your feedback is welcome and very important to the continued evolution of Practice Fusion.

Thanks,

The Practice Fusion Support Team

Become a certified Practice Fusion partner!

Do you have a business providing IT services to the healthcare industry? 

Do you work as a consultant to Medical Practices and Physicians?

If the answer is yes then you might want to take a look at the Practice Fusion partner program. 
Practice Fusion enables you to extend your clients current capabilities and provide a world-class solution to new potential clients in the healthcare market. 

Click here to download information about the program. 

Feel free to contact us at support@practicefusion.com to find out more.

Enjoy!