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Victoria doctors' offices continue switch to electronic health records

By JR Ortega
Nov. 22, 2010 at 5:22 a.m.
Updated Nov. 23, 2010 at 5:23 a.m.

Rooms full of medical charts and patient information will soon become an outdated method of storage, as electronic systems replace the doctor's script pad and heavy binders full of paper documents.


The Medicare Electronic Health Records Incentive Program will provide incentive payments to eligible professionals, eligible hospitals, and critical access hospitals that demonstrate meaningful use* of certified electronic health record technology.

Incentives begin in 2011.

Eligible professionals can receive up to $44,000 over five years under the program. There is an additional incentive for eligible professionals who provide services in a health professional shortage area.

For maximum incentive payment, Medicare eligible professionals must begin participation by 2012.

Incentive payments for eligible hospitals and critical access hospitals may begin as early as 2011 and are based on a number of factors, beginning with a $2 million base payment.

By 2015, Medicare eligible professionals, eligible hospitals, and critical access hospitals that do not successfully demonstrate meaningful use will have a payment adjustment in their Medicare reimbursement.

The Medicaid Electronic Health Records Incentive Program will provide incentive payments to eligible professionals, eligible hospitals, and critical access hospitals as they adopt, implement, upgrade, or demonstrate meaningful use of certified electronic health records technology in their first year of participation and demonstrate meaningful use for up to five remaining participation years.

The program is voluntarily offered by individual states and territories and may begin as early as 2011, depending on the state.

Eligible professionals can receive up to $63,750 over the six years that they choose to participate in the program.

Eligible hospital incentive payments may begin as early as 2011, depending on when the state begins its program. The last year a Medicaid eligible hospital may begin the program is 2016. Hospital payments are based on a number of factors, beginning with a $2 million base payment.

There are no payment adjustments under the Medicaid EHR Incentive Program.

Meaningful use means using different tools like electronic prescribing and electronic medical records exchanging between different practitioners.

Source: Centers for Medicare and Medicaid Services

Switching to electronic health records about five months ago was a full circle transition for staff at Twin Fountains Walk-In Clinic.

The clinic is one of the latest in Victoria to go paperless during the American Recovery and Reinvestment Act's push for widespread usage of electronic health records by 2015.

More Crossroads clinics are expected to go electronic once incentive programs through Medicare and Medicaid become available in 2011.

"The nicest thing about (electronic health records) is the continuity of care," Dr. John McNeill said.

Offices that have not made the switch by 2015 will be penalized by receiving decreased percentage in Medicare reimbursement, but there are no penalties for Medicaid incentive programs, according to the Centers for Medicare and Medicaid Services.

McNeill's office went ahead of the game and bought the program, called VelociDoc.

Learning to adjust to the system is one of the biggest hurdles to overcome, McNeill said.

Designed for urgent patient care, the tablet-based, web system costs anywhere from $50,000 to $100,000 plus an additional monthly fee, McNeill added.

Electronic billing, prescribing and documenting a patient's medical information can all be done from the light-weight tablet, which can be placed on a workstation dock or taken from room-to-room, said Desi Young, a nurse practitioner at the clinic.

The electronic documentation makes sharing medical records fast and efficient.

The ability to track trends in illnesses, like flu, is also easier.

"You can do the whole patient care from the computer, which is pretty cool," Young said.

Still, not every office is in a hurry to take on electronic health recording.

Of six offices contacted, two did not have electronic health records.

Dr. Charles Mabray's office is still using paper and finds no problem with documenting medical information like it has been documented since before computers, said Mandy Jacobs, office manager.

"We still have about four years. We're not in any rush to do it," Jacobs said.

Part of the reason the gynecology, bariatric and nutrition office has not made the switch is because of the cost of different electronic health record systems.

Investing in software that can run about $100,000 for an office with one doctor and two nurses can be detrimental to Mabray's practice and other small practices, Jacobs said.

"We're not that big. That could shut down a practice," Jacobs said, adding that the office sees about 20 patients a day.

The office will look into incentive programs once those become available, Jacobs added.

Other offices, like Crossroads Health Center, have been electronic for several years.

The office's records have been electronic since 2007, said Deborah Hill, office manager.

"You don't have to worry about storing records for seven to 10 years," she said.

The office's system, Greenway Medical, is also tablet-based like the system at Twin Fountains, she said.

Time management has become much easier because the nurses no longer sift through files, and billing isn't overloaded in paperwork, she said.

All the records are saved onto a server but when the system goes down, it's back to paper until the system is working again, she said.

Regardless, recording patient information electronically has changed the face of the modern-day doctor's office, she added.

"It helps on every end," Hill said. "It's a wonderful thing."



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