“CMS and Its Contractors Have Adopted Few Program Integrity Practices to Address Vulnerabilities in EHRs.” oig.hhs.gov. Office of Inspector General. Web. January 2014. A study was conducted by The Office of Inspector General in accordance with the federal council’s Quality Standards for Inspection and Evaluation. The purpose of this study was to examine the electronic health record’s fraudulent capabilities, and make recommendations to the Centers for Medicare Services (CMS) based on these findings. The OIG is a branch of the U.S. Department of Health and Human Services that was established in 1976 to protect the department’s integrity, investigate fraud, and fight waste and abuse in the healthcare system. This document was directed at CMS and included a transmittal response from Medicare in Appendix A. It was an extremely pertinent finding after much digging on the OIG website, as it will become relevant at the conclusion of my research. I intend to incorporate information provided by the OIG on the future direction of compliance risk to the medical community based upon their adaption to this new technology.
“Common E/M Errors by CERT and Medical Review.” noridianmedicare.com. Medicare Provider Outreach and Education. Web. August 2014. An outline and update provided by our local Medicare insurance carrier, Noridian Healthcare Solutions, of medical evaluation and management data compiled in February of 2014 in relation to error rates. CERT, or comprehensive error rate testing, is a post payment audit review process established by Medicare services to randomly measure the accuracy of documentation with medical-billed services. This allows the federal agencies to identify patterns of error or misreporting of services for educational updates to the medical community as well as isolating possible cases of fraud and abuse for further investigation. This source would strictly serve to provide relevant data on errors found and implications involving the documentation guidelines. The data compiled is applicable to billed services and may become necessary in further explaining or providing background to compliance concerns involving medical records.
“EHR Evolution: Policy and Legislation Forces Changing the EHR.” library.AHIMA.org. American Health Information Management Association. Web. June 2012. I was able to find a second source of information on the legislative policy and procedures involving the implementation and evolution of the electronic health record by The American Health Information Management Association (AHIMA). AHIMA is a highly reliable organization to the medical community for many years, an advocate to the healthcare professionals, and an educating organization. This organization’s reliability is also outlined in the “Integrity of the Healthcare Record: Best Practices for EHR Documentation.” article I annotate later. This source is essential to my research and defining argument as it provides an accurate historical account of the government’s actions to implement the EHR through monetary incentives. It sets the stage for this technology, so that it’s progress and complexities can be better understood and assessed currently.
“EHR Incentives & Certification.” healthit.gov. Health Information Technology. Web. 6 February 2015. Meaningful Use and its objectives are defined on this informational resource site. The Federal government to certify and measure use of the electronic health record technology, as it was adapted, implemented a program termed Meaningful Use. It was designed as a multi-stage plan to be carried out over the course of five years with incentives added for the recruitment of medical practices and provider acceptance of this new technology. The source is published on a government website with several federal agencies noted and updated in a timely manner, also a reliable source as it is defining the program straight from the direct entities involved. My purpose for this source is strictly for information and background to define for the reader the history and implementation of the electronic health record.
“Factors Affecting Physician Professional Satisfaction and Their Implications for Patient Care, Health Systems, and Health Policy.” www.rand.org. The Rand Corporation. Web. 2013. The American Medical Association (AMA) sponsored a study conducted by the Rand Corporation in 2013 to examine the professional communities satisfaction with current health policies and systems. While the overall purpose of this study was designed to plan more efficient and conducive models for physicians and clinics, many of the findings and feedback collected is pertinent to my research. The ease of EHR use and satisfaction reported within this study in combination with the implications and recommendations raise concerns on multiple levels. The Rand Corporation is a nonprofit organization, which began their mission following May 14, 1948, following a WWII project that connected military planning with development decisions. I was unable to uncover discouraging information in regard to this source and whereby find it to be a reliable non-biased company. Their primary mission statement is to “help improve policy and decision-making through research and analysis”. A great goal and much needed asset in today’s political climate of high dollar lobbying. The research they have compiled in this study will also serve to support my final web-based argument and will be greater utilized during this project.
Gallegos, Alicia. “Doctors Strike Back at EHR Vendor with Class-Action Suit.” amednews.com. American Medical Association. Web. 6 May 2013. Author Gallegos brings to the medical community a news story involving legal actions taken by a physician against the medical software vendor, Allscripts. The physician purchased this software product for use in his solo practice, and when it failed to meet the level of quality and performance promised by the vendor, he filed a class-action suit. Alicia Gallegos was a writer for three years for the American Medical Association (AMA) from 2010 to 2013. Her writing covered issues involving legal, antitrust, fraud, and liability topics in healthcare according to the AMA. I could find no further credentialing information involving this writer but remain highly confident in the source that chose this author’s work. The AMA is a driving force in medicine as a professional association for physicians and healthcare providers across the nation. Some degree of bias may exist in favor of the practitioners this association supports, but keeping that fact in mind, the AMA is still a highly credible source of information involving healthcare topics. This article provides information for my research and is the first case of its kind. It will be used in my paper, at minimum, as an example of a legal case brought against a medical software vendor for failing to deliver on a guaranteed product. A guaranteed product that carries ramifications to the providers using it, when it failed to meet federal regulations. It also outlines the negative implications and warnings to the medical community in researching and selecting an appropriate electronic health records system.
“Integrity of the Healthcare Record: Best Practices for EHR Documentation.” AHIMA.org. American Health Information Management Association. Web. August 2013. The title of this article published by the American Health Information Management Association (AHIMA) best summarizes the intent of this educational document. AHIMA addresses not only the rules and regulations surrounding appropriate documentation practices but also the ever-looming concerns of patient record integrity. The topics in this article are well outlined with supporting and relevant information that adapts well for the reader’s understanding. This national organization was founded in 1928 for the purpose of improving health record quality, according to their website. AHIMA has been a highly reliable source of information to the medical community for many years, an advocate to the healthcare professionals, and an educating organization. Not only is this a well-organized document, but also well supported with citations at the conclusion to include Federal governing bodies as well as a scholarly journal article. Another important fact I noted is the number of original authors involved in development of this information and the disclaimer of their consensus opinion and non-validation of scientific research. I plan on utilizing many areas of this source to supplement my electronic health record research. It defines specific areas of legal concern for providers, as well as the impact that poor record management may have on patient care and coordination. The level of care and reporting in documentation is extremely relevant not only to the medical community but to each of us as potential patients with our own set of electronic health records.
Leonard, Kimberly. “Doctors Say Electronic Records Waste Time.” www.usnews.com. Web. 8 September 2014. A news article was published by US News based on a small survey taken from an online internal medicine subscription source. This article is based largely on reporting of opinions with some amount of EHR historical information. While there was no comprehensive study performed, the information is relevant to clinicians’ opinions and feedback on their use of these newly implemented methods in patient documentation. Some of the views shared in this article, I have heard mirrored in the healthcare industry from providers with similar frustrations and concerns through my years of work. The source is strictly a news article and not an academic or government source, and this certainly leaves room for bias on the opinions reported. However, I still feel that provider opinion should be shared in either direction, as this is their medical practice and patient care that is being regulated.
“New CMS NPRM Offers Significant Meaningful Use Flexibility in 2015 through 2017 Program Years.” www.himss.org Healthcare Information and Management Systems Society. Web. 14 April 2015. A non-profit global organization in the healthcare industry devoted to “better health through information technology”, per their mission statement. Although I am unfamiliar with the organization, colleagues in my field working on the information technology side of the equation are familiar with this organization. It was founded in 1961 and assists the medical community through optimization of information technology. This article reviews the proposed changes by CMS to strengthen utilization of meaningful use and reduce reporting burdens. While I have reviewed the article and updates, I am not confident that this proposed rule in any way impacts the EHR integrity and patient care that my research is addressing.
Poissant, Lise, Jennifer Pereira, Robyn Tamblyn, and Yuko Kawasumi. “The Impact of Electronic Health Records on Time Efficiency of Physicians and Nurses: A Systematic Review.” Journal of the American Medical Informatics Association 2005 Sep-Oct; 12(5): 505–516. Web. Sept-Oct 2005. A study was performed to investigate the impact of electronic health records on documentation time and efficiency. The journal article was published less than ten years ago, but near and around the time that EHRs were gaining acceptance and greater use in the medical community. A scholarly source that incorporates literature and research spanning the years of 1966 to 2004 with current health databases cited. Also, a reliable source in relation to the references cited and noted throughout the journal piece, as well as the authors information and credentials as a testimony of their qualifications. This article will be useful in examining some improved efficiencies over time with continued progress of the new technology. However, I do feel it is important to cross-reference this research with newer studies in the last couple of years. A more recent study of similar magnitude may indicate continuing trends or possibly different findings as more and more user data became available.
“Common E/M Errors by CERT and Medical Review.” noridianmedicare.com. Medicare Provider Outreach and Education. Web. August 2014. An outline and update provided by our local Medicare insurance carrier, Noridian Healthcare Solutions, of medical evaluation and management data compiled in February of 2014 in relation to error rates. CERT, or comprehensive error rate testing, is a post payment audit review process established by Medicare services to randomly measure the accuracy of documentation with medical-billed services. This allows the federal agencies to identify patterns of error or misreporting of services for educational updates to the medical community as well as isolating possible cases of fraud and abuse for further investigation. This source would strictly serve to provide relevant data on errors found and implications involving the documentation guidelines. The data compiled is applicable to billed services and may become necessary in further explaining or providing background to compliance concerns involving medical records.
“EHR Evolution: Policy and Legislation Forces Changing the EHR.” library.AHIMA.org. American Health Information Management Association. Web. June 2012. I was able to find a second source of information on the legislative policy and procedures involving the implementation and evolution of the electronic health record by The American Health Information Management Association (AHIMA). AHIMA is a highly reliable organization to the medical community for many years, an advocate to the healthcare professionals, and an educating organization. This organization’s reliability is also outlined in the “Integrity of the Healthcare Record: Best Practices for EHR Documentation.” article I annotate later. This source is essential to my research and defining argument as it provides an accurate historical account of the government’s actions to implement the EHR through monetary incentives. It sets the stage for this technology, so that it’s progress and complexities can be better understood and assessed currently.
“EHR Incentives & Certification.” healthit.gov. Health Information Technology. Web. 6 February 2015. Meaningful Use and its objectives are defined on this informational resource site. The Federal government to certify and measure use of the electronic health record technology, as it was adapted, implemented a program termed Meaningful Use. It was designed as a multi-stage plan to be carried out over the course of five years with incentives added for the recruitment of medical practices and provider acceptance of this new technology. The source is published on a government website with several federal agencies noted and updated in a timely manner, also a reliable source as it is defining the program straight from the direct entities involved. My purpose for this source is strictly for information and background to define for the reader the history and implementation of the electronic health record.
“Factors Affecting Physician Professional Satisfaction and Their Implications for Patient Care, Health Systems, and Health Policy.” www.rand.org. The Rand Corporation. Web. 2013. The American Medical Association (AMA) sponsored a study conducted by the Rand Corporation in 2013 to examine the professional communities satisfaction with current health policies and systems. While the overall purpose of this study was designed to plan more efficient and conducive models for physicians and clinics, many of the findings and feedback collected is pertinent to my research. The ease of EHR use and satisfaction reported within this study in combination with the implications and recommendations raise concerns on multiple levels. The Rand Corporation is a nonprofit organization, which began their mission following May 14, 1948, following a WWII project that connected military planning with development decisions. I was unable to uncover discouraging information in regard to this source and whereby find it to be a reliable non-biased company. Their primary mission statement is to “help improve policy and decision-making through research and analysis”. A great goal and much needed asset in today’s political climate of high dollar lobbying. The research they have compiled in this study will also serve to support my final web-based argument and will be greater utilized during this project.
Gallegos, Alicia. “Doctors Strike Back at EHR Vendor with Class-Action Suit.” amednews.com. American Medical Association. Web. 6 May 2013. Author Gallegos brings to the medical community a news story involving legal actions taken by a physician against the medical software vendor, Allscripts. The physician purchased this software product for use in his solo practice, and when it failed to meet the level of quality and performance promised by the vendor, he filed a class-action suit. Alicia Gallegos was a writer for three years for the American Medical Association (AMA) from 2010 to 2013. Her writing covered issues involving legal, antitrust, fraud, and liability topics in healthcare according to the AMA. I could find no further credentialing information involving this writer but remain highly confident in the source that chose this author’s work. The AMA is a driving force in medicine as a professional association for physicians and healthcare providers across the nation. Some degree of bias may exist in favor of the practitioners this association supports, but keeping that fact in mind, the AMA is still a highly credible source of information involving healthcare topics. This article provides information for my research and is the first case of its kind. It will be used in my paper, at minimum, as an example of a legal case brought against a medical software vendor for failing to deliver on a guaranteed product. A guaranteed product that carries ramifications to the providers using it, when it failed to meet federal regulations. It also outlines the negative implications and warnings to the medical community in researching and selecting an appropriate electronic health records system.
“Integrity of the Healthcare Record: Best Practices for EHR Documentation.” AHIMA.org. American Health Information Management Association. Web. August 2013. The title of this article published by the American Health Information Management Association (AHIMA) best summarizes the intent of this educational document. AHIMA addresses not only the rules and regulations surrounding appropriate documentation practices but also the ever-looming concerns of patient record integrity. The topics in this article are well outlined with supporting and relevant information that adapts well for the reader’s understanding. This national organization was founded in 1928 for the purpose of improving health record quality, according to their website. AHIMA has been a highly reliable source of information to the medical community for many years, an advocate to the healthcare professionals, and an educating organization. Not only is this a well-organized document, but also well supported with citations at the conclusion to include Federal governing bodies as well as a scholarly journal article. Another important fact I noted is the number of original authors involved in development of this information and the disclaimer of their consensus opinion and non-validation of scientific research. I plan on utilizing many areas of this source to supplement my electronic health record research. It defines specific areas of legal concern for providers, as well as the impact that poor record management may have on patient care and coordination. The level of care and reporting in documentation is extremely relevant not only to the medical community but to each of us as potential patients with our own set of electronic health records.
Leonard, Kimberly. “Doctors Say Electronic Records Waste Time.” www.usnews.com. Web. 8 September 2014. A news article was published by US News based on a small survey taken from an online internal medicine subscription source. This article is based largely on reporting of opinions with some amount of EHR historical information. While there was no comprehensive study performed, the information is relevant to clinicians’ opinions and feedback on their use of these newly implemented methods in patient documentation. Some of the views shared in this article, I have heard mirrored in the healthcare industry from providers with similar frustrations and concerns through my years of work. The source is strictly a news article and not an academic or government source, and this certainly leaves room for bias on the opinions reported. However, I still feel that provider opinion should be shared in either direction, as this is their medical practice and patient care that is being regulated.
“New CMS NPRM Offers Significant Meaningful Use Flexibility in 2015 through 2017 Program Years.” www.himss.org Healthcare Information and Management Systems Society. Web. 14 April 2015. A non-profit global organization in the healthcare industry devoted to “better health through information technology”, per their mission statement. Although I am unfamiliar with the organization, colleagues in my field working on the information technology side of the equation are familiar with this organization. It was founded in 1961 and assists the medical community through optimization of information technology. This article reviews the proposed changes by CMS to strengthen utilization of meaningful use and reduce reporting burdens. While I have reviewed the article and updates, I am not confident that this proposed rule in any way impacts the EHR integrity and patient care that my research is addressing.
Poissant, Lise, Jennifer Pereira, Robyn Tamblyn, and Yuko Kawasumi. “The Impact of Electronic Health Records on Time Efficiency of Physicians and Nurses: A Systematic Review.” Journal of the American Medical Informatics Association 2005 Sep-Oct; 12(5): 505–516. Web. Sept-Oct 2005. A study was performed to investigate the impact of electronic health records on documentation time and efficiency. The journal article was published less than ten years ago, but near and around the time that EHRs were gaining acceptance and greater use in the medical community. A scholarly source that incorporates literature and research spanning the years of 1966 to 2004 with current health databases cited. Also, a reliable source in relation to the references cited and noted throughout the journal piece, as well as the authors information and credentials as a testimony of their qualifications. This article will be useful in examining some improved efficiencies over time with continued progress of the new technology. However, I do feel it is important to cross-reference this research with newer studies in the last couple of years. A more recent study of similar magnitude may indicate continuing trends or possibly different findings as more and more user data became available.