Unprecedented financial incentives exist for today’s physician practices to implement electronic health records (EHR) solutions. Under a Federal government program, eligible physician practices and hospitals that implement EHRs can earn up to $44,000 in incentives over a five-year period under Medicare, or $63,750 in incentives over a six year period under Medicaid. These incentives are provided under a government stimulus program known as the Health Information Technology for Economic and Clinical Health (HITECH) Act provisions within the American Recovery and Reinvestment Act (ARRA) of 2009.

Eligibility requirements for physicians to earn these incentives are dependent upon the physician’s use of a “certified” EHR, and the physician must demonstrate “meaningful use” of the EHR solution. Although the final criteria that determines a certified EHR and what constitutes meaningful use are still being determined, the Centers for Medicare & Medicaid services expects to finalize the criteria in 2010.

The industry is eagerly awaiting to hear the finalized criteria, since providers have their first opportunity to earn a portion of the incentive by demonstrating meaningful use in 2011. In short, physician practices should be well on their way to implementing an EHR or determining the EHR that they will use. The physician practices that will thrive in this current environment will be the ones that select the:

Eighty-two percent of respondents to an Ingenix survey of 1,001 physicians and practice administrators said the possibility of being reimbursed for their EHR investment makes them more likely to adopt the technology. Although the financial incentives may motivate physician practices to adopt EHR solutions, practices should remain focused on the larger goals of streamlining operations and improving performance — from both clinical and financial perspectives.

Leading EHRs have the capability of helping practices achieve these goals by:

The window of opportunity, however, is closing quickly, as system selection, implementation and training — not to mention achieving meaningful use criteria — can take upwards of a year to achieve. Web-based EHR solutions can decrease implementation time, with many of these systems having the capability to “go live” within weeks of a system selection. Traditional software-based systems can take much longer to install — often six months to a year.

Most of all, EHRs provide physicians with tools that improve practice productivity so they can focus more on patient care. Improving care quality is more important than ever as Medicare and commercial payers continue to create programs that tie a percentage of reimbursement to the reporting of care quality and patient outcome indicators. Furthermore, ARRA provisions have set penalties for providers who claim payment for Medicare and Medicaid services and are not a “meaningful user” of an EHR by 2015.

EHRs better document the care process so physicians can more easily produce the reports that payers require under their care quality indicator programs. In addition, the clinical documentation improvements that EHRs facilitate, combined with the improved access to that information, provide the tools that physicians need to manage patients with chronic conditions and the overall care delivery process.

Practices need to select the EHR that best fits their business requirements, in terms of features, functionality and workflow. Although leading EHR solutions offer the flexibility to adapt to the practice’s needs, practices need to keep in mind that they will need to adapt some of their processes to maximize an EHR’s capabilities.

Along with features, functionality and workflow, other factors needing consideration include EHR costs and how disruptive the EHR implementation and training processes will be to the practice. A recent Ingenix survey showed that these are the two top concerns among physicians and practice managers:

In terms of up-front costs and deployment, many Web-based EHR solutions can minimize these concerns. Web-based solutions offer the functionality of traditional software-based solutions, but do not require software licensing or system maintenance. Instead, Web-based systems are provided through a subscription model. Practices subscribe to the solution on a monthly basis — typically priced per physician — and pay a predictable monthly fee. Up-front costs are typically minimal and implementation headaches are decreased because the vendor hosts the solution and the practice accesses the EHR via the Web, instead of maintaining the solution in house.

Web-based solutions provide the additional benefit of improved access to patient records. With a Web-based solution, clinicians can securely access the system from any computer in the world that has Internet access. This remote access allows clinicians to view patient records, as well as prescription and refill information, lab results and more. This remote access capability is ideal for on-call clinicians who need to view patient information after hours from home or any other location. In addition, the remote access capabilities are particularly useful when clinicians are traveling for business or when they’re on vacation and need to check the status of a patient.

Basic features within EHRs include clinical notes capture, user-configured alerts and reminders, and clinical decision support. Advanced features that practices should look for in an EHR include:

These features provide the tools that practices need to earn a positive return on their EHR investments. For example:

In order to qualify for HITECH stimulus funding, practices need to use an EHR that is certified. To date, the Certification Commission for Health Information Technology (CCHIT) has served as the certifying body overseeing EHR solutions. CMS has yet to indicate if CCHIT will serve as the certifying body in the future. However, 2011 CCHIT certification standards are being developed to comply with currently proposed ARRA requirements. Therefore, practices should focus their system selection efforts on solutions that have obtained CCHIT certification.

Practices can minimize workflow disruption and better acclimate users to a new EHR by taking an incremental approach to implementation. Phasing in components of the EHR gradually will allow users to get accustomed to one area of functionality before introducing other capabilities that may result in confusion.

E-prescribing is an ideal component to initiate users to an EHR because it offers substantial benefits, while minimally impacting workflow. Within a few hours, most users can complete basic e-prescribing training on a Web-based system and begin using the solution. This initial usage of the EHR helps the practice build medication lists for patients and tracks patient prescription usage in the EHR. The convenience of electronic prescriptions and refill authorizations allows users to see immediate benefits from the solution.

Messaging is another feature that is a great way to introduce users to the EHR. Most systems offer some type of messaging capabilities, which are essentially internal ways to electronically communicate with others in the practice. Inquiries can be sent to other users of the EHR, and tasks can be electronically assigned to staff who are using the system.

Introducing electronic lab ordering is another component that can be introduced gradually and provide a high value to clinicians. Eliminating the search for lab results, since they are already in the EHR, will allow users to further see the value of transitioning to electronic processes.

As users become comfortable using initial components of the system, practices should transition to having clinicians enter their clinical notes into the EHR. Some clinicians may feel comfortable entering information into records while they are in the exam rooms with patients, while others may prefer to enter the information following the patient visit. To ease clinicians into the transition, practices can divide the introduction of electronic visit capture into components, such as:

Having providers use the electronic visit capture within the EHR will reduce administrative tasks within the practice, as clinicians will be able to select CPT and ICD-9 codes based on the services they provided and the procedures they performed. In addition, many EHRs keep track of patient visits and send reminders to clinicians when notes are not completed for individual encounters. This helps reduce lost charges and keeps clinical notes up to date.

Perhaps the most important choice that physician practices need to make is selecting the right vendor — one that can adapt to, and help practices achieve, their goals. In light of the new ARRA stimulus funding opportunities, practices need to partner with a vendor that will work with them to earn every available dollar of funding. This may include having the vendor work directly with customers to help submit the reporting required to earn stimulus funding. In addition, a carefully selected vendor will be one that is actively striving to deliver solutions that will meet certification guidelines. In fact, some vendors are offering financial guarantees that their solutions will meet or exceed future certification guidelines.

Vendors need to provide flexible solutions that allow for growth and variance within the practice. For example, one user within a practice may want to exclusively use structured templates to enter notes, while another provider at the same practice might prefer to use voice recognition or dictation. Also, vendors need to provide implementation options that accommodate the needs of the practice, rather than simply offering “one-size-fits-all” implementations.

Training is another important consideration. Vendors need to offer multiple training programs that fit the needs of the practice and individuals within the practice. While some EHR users may prefer to use pre-recorded training, others may respond better to instructor-led Webinars or onsite personalized training. On-demand access to recorded Web-based training provides users with the flexibility to train at their own pace, and at the time that best accommodates their schedules.

How the vendor approaches integration with its EHR and PM solutions can either limit efficiency gains or create new opportunities to streamline operations. Does the vendor’s EHR only integrate with its own PM solution or can it be integrated with PM solutions from other vendors? Does it freely exchange information to reduce duplicate data entry? Can the PM system pass along coding questions to the EHR so that the clinician can be queried for a response? Can the EHR populate the medication list in the PM system for billing?

In addition, practices need to seek out vendors that have established relationships with third-party organizations, which will enable the EHR to:

Ingenix offers an array of solutions and services that help physician groups enhance revenue. These capabilities are complemented with extensive regulatory compliance tools, as well as comprehensive consulting and implementation services.

Ingenix CareTracker (Version 6.2 from Ingenix is a CCHIT Certified® product for CCHIT Ambulatory EHR 2007) is a CCHIT-certified fully integrated EHR solution that physician practices can use to speed clinical tasks, such as writing prescriptions, tracking diagnostic history, entering structured text, and customizing patient notes. By combining clinical and business workflow into one Web-based system, practices can save staff time, enhance practice productivity and improve office workflow.

CareTracker is a hosted EHR solution users pay for via a predictable monthly subscription, which means practices don’t have to invest resources in hardware or maintenance costs. In addition, CareTracker is maintained and co-located at redundant HIPAA-compliant data centers.

CareTracker’s EHR application is fully integrated with CareTracker PM, a comprehensive practice management and revenue-cycle management solution that provides practices with a seamless view into their operations from any Web-connected computer in the world.

CareTracker is supported by an extensive network of partners maintained by Ingenix, which include access to nationwide networks of pharmacies, EDI clearinghouses, third-party knowledgebases and clinical applications. In addition, Ingenix provides practices with in-depth coding and referential materials to achieve maximum efficiencies in claims creation, scrubbing, billing, and reimbursement.

It’s the right time for physicians to make the move to an EHR solution, and Ingenix is the right vendor because it can address practices’ clinical and financial needs while helping physicians achieve their business goals. CareTracker is the right EHR for practices because of its flexibility, quick implementation and extensive capabilities. Physician practices that want to take advantage of the financial incentives that are being offered from CMS need to look no further than Ingenix and CareTracker for a vendor and a solution that will transform their businesses into efficient organizations.