American Medical Software Selects Intuit Health

Posted by AMS at 27 OCT 7:53 am

Wednesday, 27 Oct 2010 | 8:30 AM EST

EDWARDSVILLE, Ill. & CARY, N.C., Oct 27, 2010 (BUSINESS WIRE) — American Medical Software (AMS) has selected Intuit Inc’s (Nasdaq:INTU) Intuit Health to provide its physician practices with a patient portal solution. Through this agreement, millions of patients of AMS clients will now be able to easily communicate with their provider and complete key tasks online.

With the Intuit Health Patient Portal, the nation’s leader in patient-to-provider communication solutions, patients can pre-register, request appointments, refill prescriptions, understand and pay bills, complete medical forms, receive lab results and clinical summaries, conduct virtual office visits, and exchange messages for related care and administrative issues using a secure, online solution, anytime from anywhere. Improving patient communications, providing better accessibility, and offering tools to increase data accuracy will give staff more time to care for patients at the time of their visit.

“We’re committed to providing products and service with excellence, so we chose a like-minded company that offers impressive patient portal technology with the broadest base of coverage,” said W. David Scott, president of AMS. “Together with Intuit Health, we can offer our physician practices a great value in EMR and patient portal technology — a necessary combination for Meaningful Use.” Americans increasingly want online assistance for their health care needs. A 2010 Intuit Health survey showed that 72 percent of adults would use an online tool that would help them pay their medical bills, communicate with their doctor more easily, make appointments and get lab results. Eighty-four percent said they would complete their medical forms online before their doctor’s appointment if they had that option.

“We are pleased to be able to work with a leader in the medical software industry that can offer this solution to a large segment of small group practices to help them increase patient satisfaction, improve efficiencies and lower their costs,” said Steve Malik, president and general manager of Intuit Health. “Thousands of small group practices will now be able to enhance their physician-patient relationships by giving their patients the ability to communicate with their doctor easily, anytime, day or night.” For more information about Intuit Health provider-patient solutions, please visit www.intuithealth.com.

About American Medical Software Since 1984, American Medical Software (AMS) has led the path in providing and maintaining Medical Office Software Systems for physicians in all specialties such as electronic patient charts, billing and financial management solutions, specialty applications and more. Headquartered in Edwardsville, IL, AMS captures the majority of the nation’s small group practices to equip them with state-of-the art health information technology. To learn more, please visit www.americanmedical.com.

About Intuit Inc.

Intuit Inc. is a leading provider of business and financial management solutions for small and mid-sized businesses; financial service organizations; consumers and accounting professionals. Its flagship products and services, including QuickBooks(R), Quicken(R) and TurboTax(R), simplify small business management and payroll processing, personal finance, and tax preparation and filing.

ProSeries(R) and Lacerte(R) are Intuit’s leading tax preparation offerings for professional accountants. Intuit Financial Services’ online banking solutions and unique insights help financial service organizations better serve businesses and consumers. Intuit Health provides innovative online connected services that strengthen the provider-patient relationship.

Founded in 1983, Intuit had annual revenue of $3.1 billion in its fiscal year 2009. The company has approximately 7,800 employees with major offices in the United States, Canada, the United Kingdom, India and other locations. More information can be found at www.intuit.com.

About Intuit Health Intuit Health improves health care by developing groundbreaking clinical, administrative and financial services that connect providers and patients. We’ve combined Intuit’s legendary approach to simplifying complex tasks with Medfusion’s expertise in provider-patient communications. The result: It’s easier than ever to understand and pay your medical bills, get lab results, schedule appointments, and give patients timely electronic access to their health information. Learn more at: www.intuithealth.com Intuit and the Intuit logo, Intuit Health, among others, are registered trademarks and/or registered service marks of Intuit Inc. in the United States and other countries. Other parties’ trademarks or service marks are the property of their respective owners and should be treated as such.

SOURCE: Intuit Health CONTACT: Intuit Health Yvette Cole, 919-882-2841 yvette_cole@intuit.com or American Medical Software Kerry Robinson, 800-423-8836 krobinson@americanmedical.com Copyright Business Wire 2010

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Financial Impact of Electronic Health Record’s Use Is Considerable

Posted by AMS at 26 OCT 7:02 am

October 25, 2010 (New Orleans, California) — Medical practices that have implemented an electronic health record (EHR) system report better financial performance than those that have not, according to a new report by the Medical Group Management Association (MGMA). Results were announced here at the MGMA 2010 Annual Conference.

The findings come from the newly released Electronic Health Records Impacts on Revenue, Costs and Staffing: 2010 Report Based on 2009 Data, and were derived from a survey of 1324 single- and multispecialty medical practices. Comparative data with and without EHRs were documented, detailing total medical revenue, total operating costs, revenue after operating costs, provider costs, and net practice income or loss.

Questionnaires were mailed to 10,842 practices; 1,944 responded and 1,324 were met the criteria for analysis.

Dave Gans, vice president of innovation and research for the MGMA, who participated in the analysis, said that “EHRs provide a benefit to the patient and the physician by providing information in a way that will optimize patient care, and a benefit to the practice of a positive bottom line.”

Independent practices — i.e., those not owned by a hospital or integrated delivery system (IDS) — using EHRs reported on average $49,916 more in total net medical revenue per full-time equivalent (FTE) physician than practices still using paper records. Although these practices reported higher average expenses per FTE physician — $105,591 — they still had a median revenue $178,907 greater per FTE physician, the survey found.

The same pattern was observed in hospital/IDS-owned practices. Multispecialty practices that were hospital/IDS-owned and used EHRs reported an operating margin that was $42,042 more than the margin reported by those using paper records.

For example, a 12-member family practice group in California experienced a 15% increase in fee-for-service collections per visit with automated charge capture and integrated coding compliance features; a 50% reduction in office supply expenses by eliminating chart materials, charge tickets, and other preprinted forms; and a 10% reduction in labor costs ($100,000) in the first year of implementation, reported Rosemarie Nelson, MD, from the MGMA Healthcare Consulting Group, which is headquartered in Englewood, Colorado.

In addition, benefits grew as independent practices gained experience with their systems. After 5 years of EHR use, the average operating margin was 10% higher than it was during the first year of EHR use.

Respondents from independent practices indicated that the highest costs for EHRs occurred in the first year after installation. After 5 years, staffing for information technology per FTE increased slightly (0.13 to 0.15 people), but FTE medical records staff per physician diminished by almost half (0.34 to 1.9 people), which saved money.

Implementation Still a Challenge

“The bottom line was that practices with EHRs made more money. There are many variables, but on average revenue increased more than operating expenses, resulting in greater margins and higher profitability,” said William F. Jessee, MD, president and CEO of the MGMA.

“The potential of improved financial performance should be an encouragement for many organizations to purchase and use an EHR. Physicians adopting these technologies can also earn up to $44,000 in Medicare incentives. This is good news for practices contemplating [switching] to EHRs, although we still believe that satisfying the ‘meaningful use’ criteria and therefore qualifying for these incentives will be challenging.”

Robert Tennant, senior policy advisor for the MGMA, elaborated on the barriers that physicians face in implementing EHRs. “The existing challenge, regardless of satisfying the meaningful use criteria, is how to pick the right system — not the one earning you the $44,000 but the one that is right for your practice — how to train the staff, how to keep up productivity while implementing the system, issues of going ‘live’. It’s the challenge of designing your meaningful use program, of tracking your patients, documenting the number for whom you are e-prescribing (to meet the 40% threshold), and so forth,” he said.

With regard to the survey results, it’s not clear whether the use of EHRs increases revenue, or whether better performing practices might be the ones using EHRs, Mr. Tennant noted, but he added that, “from my perspective, it doesn’t matter. You are venturing down the same road. If you want to be successful as a medical group, the evidence points toward your having an electronic system.”

The researchers and commentators have disclosed no relevant financial relationships.

Medical Group Management Association (MGMA) 2010 Annual Conference. Presented October 25, 2010.

Sourc: http://www.medscape.com

Caroline Helwick

Doctors Making Digital Leap To Electronic Medical Records

Posted by AMS at 19 OCT 7:07 am

In a world transformed by digital data, doctors appear unscathed — collecting tons of paper charts and scrawling their prescriptions in a chicken scratch that only nurses and pharmacists can fathom.

Physicians have been slow to convert to electronic record-keeping, even though health care experts say that digital patient records bring greater efficiencies and productivity while improving patient safety.

Many hospitals across the United States have also lagged in adopting these new technologies. Nursing homes and ambulance systems have been the slowest. But a growing number of health providers in the St. Louis area are scrapping their paper charts for electronic records. Some hope to not only cut costs but also to cash in on federal incentives to digitize.

Under last year’s American Recovery and Reinvestment Act, the U.S. Department of Health and Human Services is setting aside about $20 billion in stimulus money: up to $44,000 per physician who meets the government’s criteria for investing in electronic patient records. Eventually, there will be penalties for doctors who fail to switch over. In five or 10 years, experts say, electronic medical records will be swiftly sent between hospitals and medical offices, whose computer systems, as of now, cannot communicate.

“We’re all stumbling toward the future,” said John Short, chief executive of the Clayton-based Rehab Care Group Inc., which owns and operates long term acute-care hospitals and manages therapy programs in skilled nursing facilities, “It’s a tough rollout period. I haven’t heard anyone say it’s easy.” Doctors, nurses and case managers at RehabCare Group are using about 4,000 iPod Touches, iPhones and iPads to enter patient data, triage patients and track medical records. The administration of President Barack Obama says that digital records will not only save the U.S. health care system tens of billions of dollars a year but also improve patient safety. Hard evidence of such savings is slim, but specific studies of hospitals and outpatient care centers have shown that their return on investment can be significant.

A 2006 study of Brigham and Women’s Hospital in Boston — a teaching affiliate of Harvard Medical School — found that over a 10-year period, electronic health records provided net savings of $16.7 million. Other experts say electronic records help prevent costly medication errors due to miscommunication, including misunderstood handwriting.

Medical software on the market includes tools that catch potential drug interactions or inappropriate dosing as well as alerts that highlight patient allergies. In any event, software developers expect a bonanza of medical offices and hospitals to go digital. And the emergence of the iPad — a computer tablet with a large screen — could be the shot in the arm needed for health care providers to invest. At least one local company, ClearPractice LLC, hopes to lead the way for doctors. In late September, the Maryland Heights-based firm rolled out its Nimble system — the first all-purpose medical records application designed specifically for Apple’s iPad.

REDUCING MEDICAL ERRORS About 22 percent of doctors and only 10 percent of hospitals nationwide have converted to digital patient records.

Among local hospital systems, SSM Health Care — which operates St. Mary’s Health Center and six other hospitals in the St. Louis area — was an early bird. SSM has invested about $330 million in electronic records in the past several years at its 15 hospitals in four states. “It was a huge culture change for our caregivers,” said Mike Paasch, vice president and regional chief information officer for SSM, adding that nurses adapted more readily to digital record-keeping than doctors. Beginning in 2006, SSM began installing electronic record systems in its local hospitals — replacing hard copy charts with a single, digital record that includes diagnostic tests and lab results, prescriptions and doctors orders. The records are kept with security controls in SSM’s central data base.

“It was a big change for the physician population to do order entries and many things that proxies had done for them in the past.” Paasch said. “(But) I think for the most part they recognize the value from a patient safety and patient care perspective of having all the information available at any point that they need to get to it.” He said electronic patient records had already resulted in more efficient patient care and fewer medical errors at SSM’s local hospitals.

St. John’s Mercy Medical Center, and its sister hospital in Washington, Mo., have also invested heavily in information technologies and now have fully functional electronic medical records systems, including barcodes to protect patients from receiving wrong medications. Its first medical group offices went live with digital records in early 2008, and its hospitals went live in 2009.

St. John’s Mercy also went live earlier this month with a system that provides online access for patients to view their health records, get test results, e-mail their physicians and make appointments. BJC HealthCare has lagged behind some of its competitors, but is in the process of converting all nine of its hospitals in the area to digital patient records and barcode systems.

BJC’s flagship, Barnes-Jewish Hospital, has a computer system that enables nurses and physicians to directly order medicines and helps minimize potential errors. In September, the hospital began installing a barcode system for medicines. Barnes-Jewish physicians, residents, and interns adapted “very well” to the electronic ordering system, in part because they helped design it, said program manager Pat Mueth. St. Louis University Hospital, which is operated by the Tenet HealthSystem, has also been slow to digitize, but will begin installing electronic health records systems in January. Among skilled nursing operators, the Rehab Group is plunging head first into hand-held devices.

The company has about 300 iPads in the hands of its 19,000 employees and plans to have about 3,000 in use next year in its 29 acute care hospitals, 107 rehabilitation hospitals that it manages, and the therapy programs it runs in 1,100 nursing homes. The firm relies on a “cloud-based” Internet system with software by Salesforce.com, a San Francisco firm whose customers rent data storage space.

“You’ve got to view this as a journey, not a destination,” Short said. “Basically, we’re changing the tires on a car that’s going 80 miles per hour.” Boost from iPad Some doctors offices converted to electronic records a decade ago, but those are the exceptions. Software developers have created medical iPhone applications for physicians, but the device’s small screen makes it difficult for them to read X-rays and other documents.

“Doctors themselves are really slow to make decisions, but for the first time they are really looking at switching over,” said Matina Koester, who owns St. Louis-based Digital Partners Inc., which distributes Apple products to businesses. Even so, Koester expects iPad usage to first inundate the pharmaceutical industry, with increased usage by drug sales reps. “I think we’ll see doctor’s offices move to this after the drug companies,” she said. ClearPractice began developing its iPad application six months ago, and tested it for a month in about 20 medical offices.

“Doctors took to it right away with minimal training,” said Joel Andersen, president of ClearPractice. “They’re using it in all facets of their business — at home, in the office, in front of their patients, and in the hospital. They’re finding the product to be quite intuitive.” He said doctors can use their iPads at home to review the day’s progress notes, test results and X-rays, refill prescriptions and send messages.

ClearPractice, a subsidiary of Essence Healthcare, was founded by venture capitalist John Doerr and his brother, Dr. Tom Doerr, a physician and software designer. The firm has about 90 employees, including 35 to 40 software developers and testers in Hyderabad, India. The remainder of its support and training staff is based in Missouri.

ClearPractice’s prime competitors include NextGen Healthcare in Pennsylvania and E Clinical Works of Westborough, Mass. Neither firm has an iPad application yet. Other competitors include Allscripts Healthcare Solutions in Chicago and Epic Systems Corp. in Verona, Wis. For several years, ClearPractice has marketed a Web-based system that allows health care providers to share information between hospitals and outpatient offices, but only about 500 doctors are using this system. The firm’s new iPad application is compatible with this database. The Nimble’s basic functions include reviewing and sending doctor’s reports, tests and imagery; appointment scheduling; billing records; and electronic prescribing. The system is accessible through a Web browser, an iPhone or an iPad. No patient data, such as the doctor’s diagnosis, treatment, or billing records, is stored on the iPad device itself; the iPad is connected via wireless to a data center operated by ClearPractice, and patient data is encrypted when transmitted.

Andersen said a doctor’s clinical support staff can use the device from check-in to checkout — beginning with the screening of patients, taking their vital signs such as blood pressure, capturing the patient’s chief complaint, and recording the patient’s medical history. He said about 70 percent of physicians work within a small practice of fewer than 10 doctors, and the majority of these practices don’t yet have electronic patient records. Traditionally, software vendors have focused on larger medical practices.

“We understand the small practice physician and really have the technology model and price point to really adequately serve the needs of that market,” said Andersen. ClearPractice’s monthly subscription rates run from $99 to $499. “We don’t charge for support staff. We only charge for doctors,” said Andersen, explaining that doctors usually pay for the cost of subscriptions and also supply iPads to their staff. He also said his firm can deploy its product at a rapid pace — without the need to shut down a medical practice. Doctors and their support staff learn the basics from Web training videos, and once the office goes live, they have access to ClearPractice’s technical support staff. “By the end of the year, we should have an additional 500 doctors using the system,” Andersen said.

Source: Oct 17, 2010 (St. Louis Post-Dispatch – McClatchy-Tribune Information Services via COMTEX) –

New Electronic Medical Records Software Could Improve Your Health

Posted by AMS at 14 OCT 8:03 am

Here is a simple read on how electronic medical software works in real life.

For most of my career as a family doctor, I kept track of my patients’ health histories by scribbling hand-written notes in a paper chart. For a healthy child, I’d include dates when vaccines were given; for an adult with, say, diabetes, I’d make sure to jot down a recommended schedule of blood and urine tests as well as foot and eye exams. A majority of primary care physicians, in fact, still use this kind of tracking system—despite research suggesting that these handwritten flowsheets aren’t just inefficient, but extremely vulnerable to errors. Some say the solution lies in simply switching to electronic medical records.

[6 Ways Electronic Medical Records Could Make Your Life Safer and Easier]

After all, paper charts don’t automatically update themselves when, say, the Centers for Disease Control and Prevention makes a new vaccine recommendation. An electronic medical record system can do that and can also allow test results to be emailed or transferred automatically into a patient’s chart; paper charts rely on office administrators to input them by hand, which can lead to mistakes. I, myself, have occasionally forgotten to record that a vaccine was administered during the chaos of a busy work day. Nor did I have any systematic way of knowing how many of my patients were actually receiving the preventive and chronic care they needed.

[How to Create Your Own Personal Health Record]

But the latest research suggests that electronic health records don’t necessarily improve care unless they include interactive features: They should make it easier for doctors to implement proven guidelines for good care, providing the necessary shots and screenings, follow-up exams and treatments to help patients live longer with chronic diseases or to prevent these diseases altogether. Ideally, these records should include a software tool that periodically culls through patients’ records looking for gaps in care such as who is overdue for a cholesterol screening or flu vaccine. The system would then send out reminders to patients to come in for a test or appointment.

[Electronic Medical Records: Will Your Privacy Be Safe?

Kaiser Permanente added such a tool to their electronic medical record system several years ago and found that it works to improve care. A study published last month in the American Journal of Managed Care found that the support tool brought more diabetes and heart disease patients in for health screenings, vaccinations and medication adjustments. After three years, for patients with diabetes, the percentage of care recommendations met every month increased from 68 percent to 73 percent; for heart disease patients, the percentage rose from 64 percent to 71 percent. Another study found that tool helped more healthy patients get the recommended screening and exams for preventive care. Bottom line: This support tool lowers the rate of skipped appointments and gaps in care.

This is great news if you use Kaiser Permanente for medical care, but what if you don’t? Well, you can probably expect to see some significant changes at your doctor’s office over the next three to five years. Physicians who take advantage of government financial incentives to set up electronic medical record systems must prove they’re making “meaningful use” of the data from the health records, meaning that they’ve improved patient care as a result. But now is a good time to ask your doctor about how your records will be handled in the future. Will a fail-safe system be implemented to ensure that you don’t miss crucial office visits or screenings? If you see more than one doctor on a regular basis, find out if your primary care clinician—the one responsible for coordinating all of your care—uses a system that’s compatible with the systems your specialists use. This will make it far easier to transfer test results and updates to prescriptions back and forth between various offices. Otherwise, the responsibility for keeping your medical chart up to date will fall on your shoulders. If you’re not satisfied that your doctor is staying abreast of all these technological changes, you might want to consider switching to another practice.

By KENNY LIN
Posted: October 13, 2010

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Making The Move to Electronic Records

Posted by AMS at 12 OCT 6:33 am

For Dr. Jennifer Brull, the decision to implement electronic health records in her Plainville clinic was an easy one.

“It was just a desire,” she said. “I’d had an electronic health record in residency.”

Now, Brull and her colleagues at Plainville Medical Clinic are glad they made that decision. The technology — which allows patient charts to be kept digitally on a secure network — went live in 2008, putting the rural family physicians a bit ahead of a huge national push.

The American Recovery and Reinvestment Act of 2009 includes a massive $34 billion in incentives for medical providers to improve or implement the technology. To qualify for those funds, providers must comply with a new set of federal “meaningful use” criteria issued in July.

While some hospitals and health care providers in northwest Kansas — including Brull — are trying to bring their current technology up to par with the new standards to qualify for reimbursement, others are considering taking the technological leap.

Among them is Russell Regional Hospital, which is planning to add the technology and currently interviewing vendors. But for some of the area’s small, rural hospitals, the high price tag for start-up costs could be a bit prohibitive, said Chief Executive Officer Shelley Boden.

“Cost is a huge factor,” she said. “In order to meet meaningful use criteria, as with a lot of critical access hospitals or rural hospitals, the cost associated with implementing it is going to be very challenging.”

To be sure, this technology isn’t cheap. A ballpark figure would be about $30,000 per provider, said Brull, who sits on the state’s E-Health Advisory Council.

Beginning in 2015, providers who have not successfully demonstrated meaningful use will face cuts in the amount of Medicare reimbursement they receive. It will begin with 99-percent payment in 2015, and drop to 97 percent by 2017, according to information from the Centers for Medicare nd Medicaid Services.

“So if your practice has not implemented an EHR and have meaningful use, you’re going to get reimbursed less dollars for the same service as someone who does,” Brull said. “So ultimately, people are going to be pressured to do this.”

An aggressive time frame is another challenge facing start-up providers. Money is available through Medicare and Medicaid, and providers opting for the Medicare program must achieve the first phase of meaningful use by 2011 or 2012 for optimum reimbursement.

The first phase requires that 20 of the 25 provisions listed in the new meaningful use criteria must be met, said Michael Aldridge, director of the Kansas Health Information Technology Regional Extension Center.

The Kansas government in February designated the HITREC, under the umbrella of the Kansas Foundation for Medical Care, to help health care providers overcome these challenges, which seem especially prohibitive in smaller practices, he said.

“Capital is probably the biggest barrier … Those incentives are to help offset the capital that’s incurred,” Aldridge said. “The second highest barrier was difficulty selecting a product that the practice would feel confident investing the dollars in.”

The organization is preparing a list of vetted technology vendors, and working to assist both start-up providers and practices striving to obtain meaningful use.

All vendors must be certified for providers to qualify for meaningful use, which potentially could be a concern for providers who already have made the investment. It is expected, however, that most vendors will pursue this certification to stay in business, Aldridge said.

“People that maybe have chosen products and not done that type of research might find themselves having to repurchase a product, and certainly that’s very difficult for a lot of these practices that are already (financially) strapped to begin with,” he said. “I hope that doesn’t happen with much frequency.”

In northwest Kansas, those who have implemented the technology say they are reaping the benefits. Hays Medical Center’s medical staff went live with its EHR system in 2004, and has experienced cost savings and enhanced patient safety, said Chief Financial Officer Bill Overbey.

The system includes bedside safety features such as checking for allergies and possible drug reactions. Nurses also complete digital bedside medication verification, which ensures the correct dose is being given to the right person at the right time, Overbey said.

“There are several safety precautions, and from a patient care point of view … all of the information is in one spot,” Overbey said. “It shows lab results, it shows nursing notes, it shows drugs that have been ordered, it shows progress notes, and consults from other physicians — just anything that’s been created in the process of taking care of a patient.”

Hays Med is hoping to qualify for the incentives, which could be enough to cover almost all of the initial cost, Overbey said, noting several million dollars have been invested in the technology.

Efforts also are continuing to qualify for the incentives in various clinics, either by upgrading current technology or switching vendors to obtain additional features, he said.

“We’re literally about 90 percent of the way toward meeting all the requirements for the hospital that we need to meet a year from now,” Overbey said.

As for Brull, she said she would never want to go back to the days of paper records. One of the greatest advantages, she said, has to do with quality improvement.

“In the old days of paper, when you did quality improvement, you’d pull 30 charts,” she said. “In the day of electronic, we look at our entire population. So if I’ve got 400 people who qualify for pneumonia vaccinations, I’m looking at all 400 and how many had it done.”

While the system was costly, Brull said the investment has paid off for her small practice, Prairie Star Family Practice.

“Financially, even with paying for the electronic health record, the business has been more financially profitable over the past two years since we’ve had it,” she said. “It’s been good all the way around. We don’t have anybody who hates it. We don’t have anybody who would ever want to go back.”

By KALEY CONNER
kconner@dailynews.net